Culture ClashHow We Win the Battle for

Better Health

PART IVHow to Create a New Culture By

Creating Islands of Health

Dr. Steven AldanaCEO WellSteps

Four Part Agenda

Part I. What’s the ProblemPart II. How Our Culture Has ChangedPart III. Culture is the Cause: A New Culture is the SolutionPart IV. How to Create a New Culture By Creating Islands of

Health

Review of Part III

1. Just like nutrition our ancient bodies cannot adapt to sedentary living

2. We have many examples of people who have healthy cultures for themselves

3. Healthy behavior is the key, the research proves it4. People need three things to succeed:

1. Find a reason to change2. Learn new skills3. Get help from others

How Do They Do It?

Islands of Health

Islands of Health

How to Create an Island of Health

XAwareness

Motivation

Skills

Policy

=Effective WellnessPrograms

Reach Impact

Awareness and Education

Motivation

Skills and Tools

Policy and Environment

Awareness and Education

Motivation

Skills and Tools

Policy and Environment

Culture Change for Individuals

Culture Change for Individuals

• Find a reason to change• Learn new skills• Get help from others

Awareness and Education

Motivation

Skills and Tools

Policy and EnvironmentImpact

5%

30%

25%

40%

How Wellness Professionals Change Culture

1. Awareness and Educate (Why and What)

• Create individual awareness• Create community and organizational awareness

and support• Create buzz• Brand Your Wellness Effort

• Biometric screening• HRA• Webinars• Flyers, posters• Email notifications• Television/video programs• Books

• Payroll stuffers• Internet sites• Magazines• Lunch and learns• Special speakers• Newsletters

Three Steps to Communicate (marketing)

1. Create compelling copy (written words)2. Offer something of value3. Include a call to action (what you want the person to do)

1. Creating good copy

• What are your employee’s problems?

Creating Solutions to Problems

What are your employee’s problems?• Poor Health• Weight gain• High Health risks, etc• Maybe they don’t have a problem

Employee Engagement

Employees whodon’t care

Creating Solutions to Problems

What are your employee’s problems?• Poor Health• Weight gain• High Health risks, etc• Maybe they don’t have a problem• High health care costs?• Reduced productivity?

It’s not what you want, it’s what your employees want

Think Like an Employee

2. Offer Something of Value (solutions to their problems)

• What is your value proposition?• Better health, lower weight, tastier food, fewer

medications, less stress, etc• Financial incentive• Happiness• Hope

Collateral (marketing) Materials

• Message should resonate with employees• Communicate in multiple ways and multiple times• Email, printed materials, newsletters, website,

posters, table top tents, meeting announcements, staff meetings

• SPOUSES

3. Include a Call to Action

• Register today• Sign up now• Join Us• Get screened• Take the HRA• Walk at lunch

Simpler is Better

96.4% Engagement

• 861 hospital employees• High health risks• Mostly female• High stress environment• WellSteps turnkey client

Subject Line: WellSteps: Improve Your Health and Win Great Prizes

Dear Bob,Get better health and lower weight when you participate.It’s time to report on your wellness points. Just Click here.

Karen,Your WellSteps Guide

Do you need Branding?

Wellness Brands

• Live Well• Healthy Lifestyles• Well for Life• Health Works

Feel good. Be healthy. Live well.

Simple?

Three Steps to Communicate (marketing)

1. Create compelling copy (written words)2. Offer something of value3. Include a call to action (what you want the person to do)

2. Motivate

• Before/after stories in newsletters

Motivate

Incentives– Carrots vs Sticks

Motivate

• Incentives– Extrinsic and intrinsic– Short term incentives

• Outcome based-wellness programs– Benefits based incentives– Carrots and sticks combined

• Effective communications

3. Skills and Tools (How do I do this?)

• Demonstrations• Lunch and learns• Classes• Healthy recipes• Show me how to do this

www.wellsteps.com/appss

4. Policy and Support

• Physical Environment• Policy• Social support

Supportive Environments

• Physical environments– Healthy food in cafeteria– Farmer’s market– Stress free work environment– Opportunities to be physically active

• Walking paths• Bike paths• Recess and PE at schools

– Smoke free air to breath at home– Safe place to exercise– Convenient access to healthy, inexpensive foods

• Broad Based Policies– Medical coverage for preventive services– Wellness based benefits design– No smoking policies– Flex time– Time to be healthy– Organizational support for healthy behaviors

• Social Support– Health role models (champions)– Spouses and significant others– Peer support– Supportive friends– Church, community support

Outcomes-based Incentives

• Benefits based incentive programs– Require leadership buy-in– Include sticks and carrots– Produce high participation rates– Are extrinsic motivators, we need intrinsic

Worksite Culture Change Essential Ingredients:

• Wellness committee meets and functions• Onsite coordinators respond in a timely manner to

wellness coordinator requests• Senior level executives participate• Benefits-based incentive structure in place

XAwareness

Motivation

Skills

Policy

=Effective WellnessPrograms

Reach Impact

Lifestyle Change

Fruit and Vegetable Servings

4.5

5

5.5

6

6.5

7

7.5

Baseline 6 weeks 6 months

Whole Grain Servings

4

4.5

5

5.5

6

6.5

Baseline 6 weeks 6 months

Percent of Calories from Fat

25

27

29

31

33

35

37

Baseline 6 weeks 6 months

Grams of Saturated Fat

12

14

16

18

20

22

24

26

28

Baseline 6 weeks 6 months

Grams of Sodium

2000

2100

2200

2300

2400

2500

2600

2700

2800

2900

3000

Baseline 6 weeks 6 months

Total Calories

1500

1600

1700

1800

1900

2000

2100

Baseline 6 weeks 6 months

BMI

-1.3

-1.6-1.6

-1.4

-1.2

-1

-0.8

-0.6

-0.4

-0.2

0

over weight obese

Systolic Blood Pressure Reductions mm/Hg

-3.6

-12.9

-28.8-30

-25

-20

-15

-10

-5

0

ideal high dangerous

Diastolic Blood Pressure Reductions mm/Hg

-3.5

-10.4

-14-14

-12

-10

-8

-6

-4

-2

0

ideal high dangerous

Total Cholesterol Reductions mg/dl

-15.8

-28.8

-47.3

-50-45-40-35-30-25-20-15-10

-50

normal boderlinehigh

high risk

Glucose Reductions mg/dl

0.3

-9

-46

-50-45-40-35-30-25-20-15-10

-505

normal I FG diabetes

Woodard & CurranOne Year Results

• Engineering company• 350 employees, 12 different locations• WellSteps Turnkey Solution for past 2 years• 84% participation

J Occup Environ Med. 2011 Sep;53(9):1008-12.

0.23

0.14

0

0.05

0.1

0.15

0.2

0.25

0.3

0.35

0.4

0.45

0.5

Baseline 1 year

Days of Smoking per week(decrease of 40%)

1.55

1.45

1.25

1.3

1.35

1.4

1.45

1.5

1.55

Baseline 1 year

Days of Absenteeism per Year(Decrease of 6%)

83.7

84.9

80

80.5

81

81.5

82

82.5

83

83.5

84

84.5

85

Baseline 1 year

Percentage of Time Productive(Increase of 1.4%)

0.18

0.12

0.1

0.11

0.12

0.13

0.14

0.15

0.16

0.17

0.18

0.19

0.2

Baseline 1 year

Emergency Room Visits per Year(Decrease of 33%)

2.69

2.56

2.5

2.55

2.6

2.65

2.7

2.75

2.8

2.85

2.9

2.95

3

Baseline 1 year

Health Care Visits per Year(Decrease of 5%)

Two Year Results

Population Health Management. 2012 ( In press)

2.5

3.2 3.2

2

2.2

2.4

2.6

2.8

3

3.2

3.4

3.6

3.8

4

Baseline 1 year 2 year

Days of Exercise per Week (increase of 23%)

Population Health Management. 2012 ( In press)

120

198 193

100

110

120

130

140

150

160

170

180

190

200

Baseline 1 year 2 years

Minutes of Exercise per Week (increase of 53%)

Population Health Management. 2012 ( In press)

1.62

22.1

1.5

1.6

1.7

1.8

1.9

2

2.1

2.2

2.3

2.4

2.5

Baseline 1 year 2 year

Fruit Servings per Day(increase of 15%)

Population Health Management. 2012 ( In press)

2.05

2.4

2.5

2.0

2.1

2.1

2.2

2.2

2.3

2.3

2.4

2.4

2.5

2.5

Baseline 1 year 2 year

Vegetable Servings per Day(increase of 9%)

Population Health Management. 2012 ( In press)

5 Small Business Pooled Study

Baseline %

Exercise (3+ days per week) 52.8

Exercise (90+ minutes per week) 47.8

Whole grain servings (5+ per week) 49.4

Vegetable servings (2+ per day) 67.5

Fruit servings (2+ per day) 45.0

Nights of restful sleep (4+ per week) 48.1

J Occup Environ Med. 2012 Oct 4

71.9

69.6

59.2

76.7

76.1

70.8

Year 1 %

Rural Wisconsin Health Cooperative (RWHC)

• One year results with WellSteps• 60 Employees• 94% participation• Significant changes in behavior and productivity

J Occup Environ Med. 2012 (in press)

2.89

3.5

2.5

2.6

2.7

2.8

2.9

3

3.1

3.2

3.3

3.4

3.5

Baseline 1 year

Day

s of

Exe

rcis

e pe

r w

eek

Days of Exercise per Week

J Occup Environ Med. 2012 (in press)

1.43

2.1

1

1.2

1.4

1.6

1.8

2

2.2

Baseline 1 year

Fruit Servings per Day

J Occup Environ Med. 2012 (in press)

2.89

3.5

2.5

2.6

2.7

2.8

2.9

3

3.1

3.2

3.3

3.4

3.5

Baseline 1 year

Vegetable Servings per Day

J Occup Environ Med. 2012 (in press)

1.34

1.1

0.5

0.6

0.7

0.8

0.9

1

1.1

1.2

1.3

1.4

Baseline 1 year

Days of Absenteeism per Year

J Occup Environ Med. 2012 (in press)

84

86.2

75

77

79

81

83

85

87

Baseline 1 year

Percentage of Time Productive

J Occup Environ Med. 2012 (in press)

What Else Can We Do?

• Linkedin: Wellness is a Business Strategy• Attend your state and national conferences• Get involved with advocacy groups• Faith-based efforts• Purchase healthy options

Percent of Americans Who Are Obese

Estimated

Percent of Americans Who Are Obese

• Our poor health is a side effect of our Western culture• Our culture will NOT change on it’s own• The ONLY solution is to create our own culture of health:

an Island of Health at home and work• Eventually these islands will connect, then, and only then

will the larger culture change

Summary