Using Data to Create Wellness Programs that Work

HR Magazine, Nov, 1999 by Michelle Neely Martinez

Ask the right questions up front to build programs employees will use and bosses will applaud.

What do you get when you start a wellness program without determining what your employees need, want and will use? "The kiss of death," according to Dr. David Hunnicutt, president of the Wellness Councils of America (WELCOA).

Eighty percent of U.S. companies offer employees at least one activity to promote health at work, according to the National Center for Chronic Disease Prevention and Health Promotion, part of the U.S. Centers for Disease Control. But to make sure those activities reap benefits for employees as well as employers, gathering preliminary data is a crucial first step. And strong data to back your wellness proposals will help you sell top management on the idea that wellness can translate into dollars saved.

Instead of jumping right into offering walking programs, launching nutrition or stress management courses or breaking ground for a new fitness facility, you first should collect data and do research to target health promotion activities that net results. "Without collecting data beforehand, the real needs of the company go unnoticed," says Hunnicutt.

Learn from the mistakes of a Midwestern company that started its wellness program by building a state-of-the-art fitness facility and implementing a campaign to combat prostate cancer. The fitness center was a hit among employees because the majority already participated in regular exercise, but the prostate cancer campaign wasn't well received.

Instead of conducting an assessment of needs before implementation, the company did analysis after the fact and discovered that 70 percent of the employees were women of child-bearing years, a majority of employees were physically active and employees' smoking rate was high. Health care claims still were soaring because the programs addressed the wrong needs--like prostate cancer--instead of the right ones, like smoking cessation and women's health issues.

Business Needs, Employee Interests

Before collecting data, form a small team of people from varied departments--including HR, finance, line management and top management if possible-to collect and analyze the data.

"Ask yourselves what the outcome goals are before you begin the evaluation process," says Catherine Hawkes, assistant vice president of the "Working Well" program offered by Cigna, the health care services provider based in Philadelphia.

According to Hunnicutt, companies should ask two questions: What does the business need to get out of its health-promotion efforts, and what do the employees want?

"If you ignore the first question, sooner or later your health-promotion efforts will get downsized our of existence," Hunnicutt says. "You have to provide a business benefit to justify your existence." If you don't address the second question, "You will set up your program without knowing what the employees are interested in. You need to know what's going to attract participation and enthusiasm from the onset."

Data on business needs focus on how employee health affects the financial well-being of the employer. To find these data, take a look at medical claims and disability claims, and then ask questions such as these: How much is the business paying for employee medical care and disability? Are there trends in the claims data? Are disability claims related to injuries from heavy lifting, repetitive motion or stress due to extensive travel?

One of the first places HR practitioners go for this kind of information typically is to the company's health care provider. While an obvious and good place to start, providers look only at one aspect of medical needs, says Yonnie Chesley, president and CEO of Gordian Health Solutions, a Nashville, Tenn.-based health management company. Chesley cautions that many health care providers look at medical cost data from the supply side, such as how many hospital visits were used by employees or how many users sought the services of specialists. This information is not specific enough.

"What employers need to be looking at is the demand side of the business, such as why people are seeking care and what those cost buckets are," Chesley says.

Medical records are not the only source of data on business needs. Others include:

* Facility assessments. Because poor facilities can contribute to employee health problems, facility assessments review the health and safety of the office environment including lighting, lunchrooms, security, cleanliness, temperature, fire safety, flooring and space limitations.

* Absenteeism rates. Absenteeism is a good indicator of the health as well as the morale of employees. Look for trends in the data and increases or decreases in the number of days missed over several years.

* Health risk appraisals. These surveys ask employees about their health habits and family histories. The responses can help identify behaviors that may harm employees' health. Appraisals could include questions about physical activity, smoking, sleeping patterns, depression, stress, seat belt use and nutrition.