IS YOUR Wellness ROI GOING UP? Evidence-Based HRA Helps Washburn Assessing the Population When the Student Recreation and Wellness Center (SRWC) opened on the University Create a Culture of Health campus in 2004, the 37,000-square-foot fitness facility re-energized on-going efforts to create an employee wellness program, says hen 57-year-old Tara Porter shows up at Washburn SRWC Director Joel Bluml. The three-court gymnasium, fitness equipment, WUniversity’s rock climbing wall in the school’s Student rock climbing wall, and indoor track provided the perfect setting to house the Recreation and Wellness Center, someone usually asks her if Washburn University Employee Wellness Program. she needs help or wants to sign up for a class. She smiles, grabs her climbing gear and says, “Thanks. But I’m already rock- When university president Jerry Farley gave a green light to move forward with wall certified.” She tightens her climbing harness, clips in her launching an employee wellness program, the first wellness screenings using carabineer, and starts climbing the 30-foot wall. the Wellsource® Personal Wellness Profile™ Health Risk Assessment were Tara Porter is one of the organized by Bluml and then Wellness Coordinator Celeste Ehrenberg. The In the past year, Tara has taken up rock climbing, started going 900-plus employees at current Wellness Coordinator Coletta Meyer joined the team in 2013. She is Washburn University About Washburn to weekly yoga classes, completed a race, and participated responsible for actively managing the program, developing interventions, and who participate in the University in monthly health challenges. It’s all part of the Washburn school’s employee providing wellness consultations to University employees. University Employee Wellness Program designed to create a wellness program. Washburn University was founded culture of health. “I’m here to help as many Washburn University employees as I can achieve a in 1865 and is a top-ranked better state of wellness,” says Meyer. “Not all of us are at the same place, but our Midwestern public university “I was on the fence about the wellness program for a long time,” says Porter, who program is designed for all employees regardless of their wellness state. We’re located in Topeka, . works as an advisor at the university. “I pretty much had it in my mind that I didn’t here to support and guide people as well as provide healthy opportunities that About 1,000 faculty and staff have time for it. When five o’clock rolled around, I just wanted to go home and facilitate growth in the multiple dimensions of health and wellness.” members work at Washburn crash or do other things.” University attended by 6,900 Washburn University In the first year of the wellness program, about 48 percent of Washburn undergraduate and graduate Employee Wellness And then one day, it happened. Tara decided to get involved in the University’s employees completed the biometric screening and health risk assessment. And students. Washburn University wellness program on her own terms. It’s the kind of success story every since then, improvements to the wellness program have increased engagement Program offers classes in more than 200 wellness coordinator dreams of after all the efforts to increase engagement, to achieve a 64 percent participation rate that continues to grow. Joel and Benefits-Eligible Employees academic disciplines, including create a culture of health, and generate ROI. Coletta also discovered the value of partnering with the right people to make 936 professional programs in business sure tests like waist circumference, blood pressure, cholesterol, glucose, and Participation Rate Now Tara is an ambassador for the University’s wellness program that and law. Washburn University was body composition are measured correctly as part of the screening process. 64% enjoys a 64 percent participation rate, successful wellness initiatives, recently ranked one of the Top Estimated ROI and an estimated $4 million in ROI since the program launched 100 Best Regional Universities by $4 million in 2006. And at the heart of this thriving wellness program is the U.S. News and World Report. since 2006 evidence-based health risk assessment by Wellsource. Discovering the Results “One of the things I really like about the Personal Wellness Presidential Support Profile™ is the readiness for change factor,” says Bluml. Washburn hen HRA reports were made University Wavailable, one Washburn University “We can identify the health risks we should focus on, which is nice. But we President Jerry professor reviewed his test results and are also able to see if people are ready and willing to change, which has the Farley is an found that his numbers didn’t match up potential to be transformative.” avid runner with healthy standards, Bluml recalls. “Assisting people with quitting smoking is a good example. If we learn that who logs an average of eight miles a day in “His numbers were off by so much, people who smoke aren’t ready to quit, promoting a smoking cessation program between meetings, speeches, he thought something must be isn’t going to work. Understanding their readiness to change allows us to begin press conferences, and an wrong with the test results,” says with an intervention that can start at pre-contemplation, get them thinking exhaustive travel schedule. He Bluml. “That motivated him to about quitting, and then move them towards taking action.” recently received the Living schedule another screening For Washburn University employee Jeremy Wangler, the HRA results that Well at Washburn award for his with his doctor, and that’s when he found out he had showed him he had high triglyceride and low HDL levels got him thinking commitment to health and well- cancer. Luckily, the cancer was caught early on and about improving his eating and exercise habits. But it wasn’t until he watched the ness and support of the Student treated successfully.” documentary, Forks Over Knives, that he was ready to change. He adopted a Recreation and Wellness Center TheWellsource® Personal Wellness Profile™ HRA plant-based diet, started exercising, and lost 80 pounds. Jeremy was able to lower and employee wellness program. reporting tools helped identify major risk factors his triglyceride level and raise his HDL to a healthy level. His positive results “Washburn University has made a for Washburn University employees. Results from motivated some of his family members to make healthy lifestyle changes too. substantial investment in wellness, the Executive Summary Report showed that “We’re seeing individuals make changes to improve their health more and more but it is really an investment in the leading health risks for university employees as our participation rates increase,” Bluml says. “Our aggregate data indicates our employees,” says President included high blood pressure, high cholesterol, that many of the employees participating in our program are on the zero-trend Farley. “Most of us spend almost as stress, lack of exercise, and weight management. Dee Eddington talks about. In other words, if we can keep people’s health risks much time with our work family The reporting data also provided valuable from getting worse, we feel we’re doing a good job. Our data also highlights that as we do with our own family. information to help make decisions about what employees who have participated in our wellness program since its inception Our wish for every member of areas to focus on and what interventions would have improved their wellness scores from year to year, and they’ve improved the Washburn employee family be the most effective. significantly as a group.” is to be happy and healthy.”

Washburn University President Jerry Farley wears #103 in the 5k Fun Run. “It’s really rewarding to meet employees in person Wellsource Products Managing Interventions and Incentives and design customized programs to help them be Used by Washburn e provide a lot of different programming options to encourage successful and make healthier choices,” says Meyer. University participation and address the key health risk factors in our population,” W After completing the Personal says Meyer. Bluml provided this analogy, “Our approach to getting the “We talk about their HRA scores and risk factors, their job, and things going Wellness Profile™ Health Risk message out there is more like a dripping faucet than a fire hose. Constant on in their life. I do individual fitness testing with employees and provide Assessment, Washburn University reminders about healthy living will get more results than overwhelming them with an exercise prescription. It’s a great way to help people employees have access to the people with a plethora of information all at once.” Washburn employees can see where they’re at, give them some goals to work towards, Wellsource Healthy Living be seen providing healthy snack options at meetings. The EWP encourages and teach them how to exercise and live healthier.” Guidelines™ videos to learn employees to participate in the Alumni Fun Run/Walk. A weekly email, more about their results, risk Wellness Wednesdays, is filled with health tips and information. “Our goal Employees who participate in the Washburn University factors, and actions they can is to create constant buzz on campus about wellness. Does it mean everyone wellness program can earn incentives valued at up to take to improve their health. at Washburn is living healthier? No. But wellness is definitely on people’s $150 a year based on three levels of participation. It’s one of the many tools the minds,” according to Bluml. Employees can earn incentives by completing the Personal Wellness Profile™ HRA and health Washburn University Employee Wellness interventions at Washburn also screening, exercising 30 minutes a day, getting Wellness Program uses to engage include a series of six- to eight-week classes preventive exams, practicing safe driving and educate their employees to offered throughout the year to help people habits, and making healthy lifestyle choices. make healthy lifestyle choices. set personal goals for health and wellness, Many employees use the financial incentive eat healthier, get more exercise, and to be reimbursed for the annual fee to use even train to complete the 5K Alumni the Student Recreation and Wellness Center. Fun Run. In addition, there are team Others choose to be reimbursed funds they challenges, wellness-focused quizzes and have contributed to their health-related mini-assessments, lectures, and friendly flexible spending account or elect to have competitions where employees can win the incentive placed on their university a healthy lunch for their entire office. identification card which allows them In addition to regular updates Employees also have the opportunity to spend the funds as cash on campus. in the WellSuite® Portal to to meet individually with Wellness Employees can even be reimbursed communicate with employees, Coordinator Coletta Meyer for one-on- the Washburn University for the costs of an outside gym one wellness consulting. Employee Wellness Program membership. also includes a weekly Wellness Wednesdays email with health tips and information. Choosing to use a more conservative $4.30 to $1 return Calculating ROI on investment in wellness, the Washburn University Employee Wellness Program estimates it has generated The Wellsource® Productivity and Economic Benefits Report (PEBR) is approximately $4 million in savings since it launched in one tool organizations use to calculate their financial savings by offering a 2006. wellness program. Using participant data from the HRA, the PEBR provides information on projected savings in healthcare costs, absenteeism, and “I think it’s important to point out that ROI is more than productivity. This report can also calculate projected savings by the just a number,” says Bluml. “It can include everything overall number of health risk factors reduced in an organization. from improvements in employee morale, employees who look and feel better because they are in better health, lower It’s one way to calculate wellness ROI. Some organizations compare healthcare costs, reduced accidents on the job, decreased actual healthcare costs from year to year. And Washburn absenteeism, and increased productivity. Research also University uses another approach. suggests there is a positive correlation between employee “When we were trying to wrap our minds around the ROI wellness programs and employee recruitment, retention, piece of administering a wellness program, we decided reputation, and presenteeism.” to utilize the meta-analysis on wellness ROI by Larry Chapman published in the American Journal of Health Promotion,” says Bluml.

“It’s based on 62 studies that show a program

March/April 2012 Meta-Evaluation of Worksite Health structured similar to ours Promotion Economic Return Studies: 2012 Update

Larry S. Chapman, MPH

Setting the Stage N Summary of results of meta-evaluation at Washburn can consider Summary of individual study findings N Two earlier editions of The Art of Health Promotion reported formal N Discussion of key findings meta-evaluations of economic return studies of worksite health N The Harvard Meta-Analysis: a significant new finding promotion programs.1,2 These meta-evaluations were among the most popular articles in our publishing history because practition- ers, scientists, and employers continue to seek evidence on the Study Inclusion Criteria economic effectiveness of workplace health promotion. The 2003 The study selection or inclusion criteria used remained the same for this report examined 42 peer-reviewed journal articles that met the update as for the two earlier reports. In addition, for the purposes of this using a 6 to 1 return inclusion criteria, and the 2005 report examined 56 peer-reviewed updated meta-evaluation, articles classified as ‘‘program evaluations’’ by journal articles. This 2012 update examines 10 additional studies Medline were included if they met all of the following criteria: that met the same set of inclusion criteria; four of the weaker studies were dropped, resulting in a total of 62 studies in this report. 1. Multicomponent Programming. Qualifying articles must The meta-evaluation method used here is the same as used in report on programs that include any combination of a the earlier reports and has been adapted from use with other minimum of three of the following types of program preventive health programs, providing an overall summary and interventions: smoking prevention and cessation, physical individual look at the quality of the peer reviewed articles that fitness, nutrition, stress management, medical self-care, high on investment ratio to comprise the current scientific evidence of economic return for blood pressure control, cholesterol reduction, cardiovascular worksite health promotion and wellness programs. disease prevention, prenatal care, seat belt use, back injury The term ‘‘meta-evaluation’’ as used in this article is defined as the prevention, back pain prevention, weight management, and application of a systematic review process to a set of evaluation nutrition education. studies with a similar purpose in order to determine their respective quality and to summarize their primary findings. It applies the formal meta-evaluation review process and methodology developed and refined by Windsor and Orleans3 and further modified by Boyd and Windsor4 to studies of multi-component worksite health promotion In This Issue calculate wellness ROI.” 5 Meta-Evaluation of Worksite Health Promotion Economic programs as defined by Heaney. This report include excerpts from the book Proof Positive: An Analysis of the Cost-Effectiveness of Return Studies: 2012 Update Worksite Wellness, seventh edition, revised and expanded in by Larry S. Chapman ...... 1 December of 2011,6 which applies the same methodology. References ...... 10 This edition of The Art of Health Promotion addresses the Selected Abstracts ...... 11 following topics: Closing Thoughts, by Larry S. Chapman ...... 13

Study inclusion criteria Editorial Team N Editor ...... Larry S. Chapman, MPH Literature search process N Publisher ...... Michael P. O’Donnell, Description of meta-evaluation approach N PhD, MBA, MPH Managing Editor ...... Danielle J. Price, MA DOI: 10.4278/ajhp.26.4.tahp

TAHP-1 Read the AJHP article Washburn University uses the on wellness ROI tinyurl. WellSuite® Portal, customized com/kqf2vf5 with its own logo and colors, to engage employees and administer the Wellsource® Personal Wellness Profile™. Making a Difference Lessons Learned With a 64 percent participation rate, Joel and Coletta know 1. Sustained efforts to create a culture of there’s still room for improvement to engage more university health increase engagement. faculty and staff members. Managing an effective wellness program is always a work in progress. And you never know when some wellness message, email, or invitation to 2. A Health Risk Assessment can save someone’s life. participate in a health challenge will motivate someone like Tara Porter to take action, get involved, and improve their 3. Effective interventions require knowing your health and their life. population’s risk factors and readiness for change. “We evaluate every single program that we run, and then we make changes to improve it,” says Meyer. “We work pretty 4. Support from leadership can help hard at providing a variety of wellness programming options encourage participation. to have the best impact and reach the most people. Our goal is to educate employees about healthy lifestyle choices and 5. Multiple delivery platforms work best to encourage them to participate in quality programs that will enhance their health and quality of life.” distribute wellness program information. 6. The right incentive can motivate people to make healthy lifestyle choices. 7. Successful wellness programs evolve and change over time to keep participants engaged. 8. The Wellsource® HRA provides valuable data to help identify risk factors for a population, choose Washburn University Employee Wellness coordinator Coletta interventions, and measure wellness program results. The Washburn University Meyer and Student Recreation Washburn University has been making employee wellness program has and Wellness Center Director strides in education and employee achieved an estimated $4 million Joel Bluml manage the school’s wellness since the school was named after in wellness ROI since 2006. thriving wellness program. philanthropist . For information on how to make your ROI climb, call us at 800.533.9355 or visit www.wellsource.com