A Dietitian’s Role in a Government Employee Health Program

LCDR Sandra Magera, MS, RD, CDEU. 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:

• We accomplish this through:

– Comprehensive suite of wellness and health education programs

– Programs based on each individual’s readiness to change

– Maximum engagement through total integration and linkages

– Creation of a supportive social and physical environment

– Continuous evaluation and improvement

• 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

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

First Lady Michelle Obama and HHS

Secretary Kathleen Sebelius both spoke to the importance of

the FedStrive Employee Wellness

Program on October 13, 2009.

Employee Engagement and Cultural ChangeThe 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 Self-Rating

• Existing Medical Conditions• Risks for Cardiovascular Heart

Disease• Blood Chemistry• Activity Levels and Other

Readiness for Exercise Criteria

• Weight Management• Use of Medical services and

screenings• Personal Safety habits• Eating habits/patterns• Substance Use / Abuse• Psychological, Social, Cultural, 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 rolesin 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• Policy Makers

Think outside the lunch box!

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

Monday – 9th Tuesday – 10th Wednesday – 11th Thursday – 12th Friday – 13th

What does a Balance Meal

consist of?

•Grains – 6oz(1 oz equivalent is 1 slice of bread, 1 cup of dry cereal, ½ cup cooked rice, pasta, or cereal)•Vegetables – 2 ½ cup(broccoli, peas, dark greens, some starches, dry beans)•Fruits – 2 cups(1 cup of grapes, medium size apple or banana)•Milk – 3 cups•Meat & beans – 5 ½ oz(lean meats, 1 oz of poultry or fish, 1 egg, 1 tsp of peanut butter)

*Based on a 2,000 calorie diet.http://www.cdc.gov/healthyweight/healthy_eating/fruits_vegetables.html

How to read a label?

Always check the daily value (%DV) on a label.•5%DV or less- LOW•20%DV or more – HIGH

Check the serving size and calories•40 calories is low•100 calories is moderate•400 calories is high

Limit your intake•Sodium•Cholesterol•Fat (trans, saturated & total)

Make your calories count!http://www.accessdata.fda.gov/videos/CFSAN/HWM/hwmsk02.cfm

For reliable health information!www.womenshealth.gov

Physical Activity

Adults need at least 30 minutes of moderate to vigorous activity a day!

Moderate activity:•Walking Fast•Water Aerobics•Lawn Mowing

Vigorous activity:•Jogging or running•Swimming laps•Playing basketball

Compute your heart rate for best workout!http://www.cancer.org/healthy/toolsandcalculators/calculators/app/target-heart-rate-calculator

Calories burned?http://www.cancer.org/healthy/toolsandcalculators/calculators/app/exercise-counts-calculator

Risk factors of disease?

Controllable

•Smoking

•Obesity/Overweight

•Noncompliant of

Medications

•Unhealthy Diet

•Sedentary Lifestyle

•Stress

Uncontrollable

•Age

•Sex

•Race/ Ethnicity

Health Data?http://www.womenshealth.gov/statistics/

Importance of updated health information

•Insurance Info•Emergency Contact•Medications

Your Family History may affect your future health!

Do certain diseases and/or health conditions run in

your family?

Are you due for an annual checkup?

Build Your Questions List!http://www.ahrq.gov/questionsaretheanswer/questionBuilder.aspx

My Family Health Portrait!https://familyhistory.hhs.gov/fhh-web/home.action

http://www.cdc.gov/family/checkuplist/index.htm

Office on Women’s Health

May 8 – 14, 2011

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.

Fedstrive Event Attendance 10/2009 through 10/2010

250 175

374

275

1,900

106

750

0

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600

900

1200

1500

1800

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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 890Health Education Classes 18Education Class Attendance 410Monthly Gym Memberships 481Dietary Consultations 135Team Lean Challenge Participants 106Weight Loss by TLC Participants 364Tobacco Cessation Participants 11

Risk Stratification

52%17%

31%

Low (0-2 Risks)

Moderate (3-4 Risks)

High (5+ Risks)

Common Medical Conditions (percent)

29

20

18

12

9

8

7

7

4

4

0 5 10 15 20 25 30 35

Allergies

High Cholesterol

High Blood Pressure

Neck/Back/Musculo Pain

Anxiety/Depression

Arthritis

Asthma

Migraines/Headaches

Metabolic Disease

Diabetes

BMI Categories

1%

27%

37%

35%

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.gov5. www.motorola.com6. www.pfizer.com7. http://www.fsis.usda.gov/fsdiscoveryzone 8. http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm257499.htm9. Photo of HHS Secretary Sebelius contributed by PHS Officer LCDR Loren Rodgers