APUS Wellness Program Paper

Pronk, N. (ed.) (2009). ACSM's worksite health handbook, 2 ed.-- A guide to building healthy and productive companies.  *Chapter 38: Introducing Environmental Interventions at the Dow Chemical Company to Reduce Overweight and Obesity Among Workers.

Pronk, N. (2009). ACSM's worksite health handbook, second edition -- a guide to building healthy and productive companies. ACSM's Health & Fitness Journal, 13(3), 42-45. doi: 10.1249/FIT.0b013e3181a1e999 ACSM's Health & Fitness Journal

Mayo Clinic. (2013).

Calories and weight loss.  Complicated, yet simple. Mayo Clinic Health Letter

(English Ed.), 31(3), 6.

After reading the above articles, and using any additional relevant (and appropriate) research articles, please address the following:

1.  How do we integrate, into our corporate wellness programing, what we know about the factors that influence weight loss and management?2.  What role do specific variables/factors like mode of exercise, frequency, duration, intensity, and volume play in our corporate wellness program design?  Remember to include the important elements of progression, enjoyment,  & challenges/competition/goals.3.  Provide an example of what your program would look like using specific program variables. (The company this should be designed/written/created for is General Motors (GM)). Worksite Health Promotion by Nico Pronk, Ph.D., FACSM, FAWHP ACSM’S Worksite Health Handbook, Second Edition A Guide to Building Healthy and Productive Companies T oday’s worksite health promotion practitioners, including exercise physiologists, personal fitness trainers, occupational health nurses, health educators, and dietitians, among others, are faced with the challenge of generating more health among workers and their families to address employer concerns related to health care costs and health-related productivity loss. A need exists to provide easy access to useful, practical, and programmatic information that is couched in evidence of effectiveness. Where do you go to gain access to information that is credible, organized, comprehensive, and sensitive to the specific needs of frontline operational realities? The second edition of ACSM’s Worksite Health Handbook (1) is designed to provide you with the answers. MAJOR AIMS OF THE BOOK The influence of worker health on health care (direct) costs and health-related decrements in productivity (indirect costs) has become increasingly apparent over the past decade. Research studies provide more and more evidence of effectiveness that interventions designed to improve the health of the employee generate positive impacts on costs V both direct and indirect costs. However, translation of the key research findings into practical and applicable solutions has been lacking. How do research-supported principles, strategies, and tactics find their way into day-to-day operations? This book has as its major aims: • To connect worksite health research and practice. • To provide a framework that supports integration of worksite health promotion 42 into a broader set of health-promoting strategies (including environmental, cultural, and organizational, etc). • To provide access to information that illustrates an explicit connection between worker health and business performance. HISTORY OF THE INDUSTRY AND FRAMEWORK OF THE BOOK Overarching historical perspectives are provided in several chapters, although a focused presentation of the history of the employee health management field is discussed in depth. A thorough understanding of the history will provide a level of appreciation of where the field is today and how it may grow and evolve into the future. Furthermore, it provides appropriate context on the possibilities and opportunities for integration into other health-promoting or health-protecting areas, such as occupational medicine, occupational health services, worker safety, and so on. Figure 1 presents a historical timeline that highlights noteworthy events related to the worksite health field. ACSM’s HEALTH & FITNESS JOURNALA | www.acsm-healthfitness.org Copyright @ 2009 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited. VOL. 13/ NO. 3 To support the notion that a comprehensive multicomponent worksite health promotion program reflects an employersponsored population health management strategy, a framework is introduced in the book that aligns a comprehensive set of worksite healthYrelated factors. It explicitly recognizes that in a population health management model, four levels of prevention are at work, need to be optimally integrated to function, and are inclusive of individual, interindividual, organizational, and environmental levels of intervention. These four levels of prevention include primordial, primary, secondary, and tertiary prevention. The Table provides operational definitions of each of these levels of prevention and includes a description of the target groups for such efforts. The overall framework illustrates a population health management strategy at the worksite and provides an opportunity to place key questions into proper context for discussion or dialogue. WHAT’S IN THE BOOK? For the purpose of this column, Figure 2 presents an overview of topics presented throughout the book and how they relate to each other. The book is organized into five sections: • Part I: Setting the Context • Part II: The Evidence for Employer- Sponsored Programs • Part III: Assessing Worker and Organi- zational Health • Part IV: Program Design and Imple- mentation • Part V: Case Studies Figure 1. Population health promotion among workers V a historical timeline. An overview is provided of contextual issues including population health management principles applied to the worksite, the history of the field, the current state of the field, legal perspectives, VOL. 13/ NO. 3 ACSM’s HEALTH & FITNESS JOURNALA Copyright @ 2009 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited. 43 Worksite Health Promotion TABLE: Prevention Classifications and Definitions Level of Disease Prevention Brief Description Primordial Primordial prevention addresses the underlying conditions that may lead individuals or populations to become exposed to causative factors for disease V it is intended to prevent the occurrence of risk factors in the population. The goal is to address social and environmental conditions that create health-damaging exposures and susceptibilities among the population. Primordial prevention strategies may apply to subgroups (of particular interest due to exposure to specific conditions) or the total population. Primary Primary prevention intends to limit the incidence of disease by controlling causes and risk factors. It may apply to the total population with the aim of reducing average (overall) population risk, to particular subgroups of interest, or to individuals at high risk for a particular condition. Secondary Secondary prevention is intended to cure patients and reduce the more serious consequences of disease through early diagnosis and treatment. It is directed at the period between onset of disease and the time of diagnosis and aims to reduce the prevalence of disease. The target populations for secondary prevention are population subgroups at elevated risk and established patients. Tertiary Tertiary prevention is intended to reduce, mitigate, or limit the progress or exacerbations of diagnosed disease and is an important aspect of therapeutic and rehabilitative medicine. Its target population is established patients. (Reprinted from A guide to building healthy and productive companies. In: Pronk NP, editor. ACSM’s Worksite Health Handbook, Second Edition. Champaign, (IL): Human Kinetics; 2009. p. 8. Copyright B 2009 Human Kinetics. Used with permission.) and the role of health policy on worksite programs. An introduction to the role of evidence of effectiveness and systematic reviews on worksite health promotion topics opens the door to a discussion on how to translate research into practice, benchmarking and best practices, and health and productivity management processes. The connection between health and the organization of work is discussed in depth. Next, an entire section of the book is dedicated to assessment, measurement, and evaluation. An overview of using evaluation for the purpose of improvement is provided based on the U.S. Centers for Disease Control and Prevention model for program evaluation. Assessment of health risks is discussed for both individuals and organizations, and tools that may be used for the assessment of employee productivity are presented, compared, and contrasted. The proper use of claims and measurement issues for calculation of return on investment are highlighted as well. 44 The main section of the book centers on program design and implementation. Data organization and use to optimize program engagement and participation and the consideration of behavior change theories are directly applied to program design issues. This section also presents thorough discussions on the importance of keeping healthy people healthy, connecting worksite health promotion programs to the core business objectives, addressing diversity and health literacy, rewarding change through meaningful incentives, and integration of health promotion with occupational health services. The importance of a culture of health and the built environment is considered a major emerging issue, and the use of eHealth strategies, online communities, and Web-based portals is described in detail. Both medical selfcare and disease management strategies are discussed before pulling all the components together into a single chapter that describes the process of programming and implementation. The last section of the book presents four in-depth case studies that collectively represent the broad range of companies that implement comprehensive multicomponent worksite heath promotion programs. These case studies report on the experiences of small (self-employed) Figure 2. Interrelationship of book chapter content for ACSM’s Worksite Health Handbook, Second Edition. ACSM’s HEALTH & FITNESS JOURNALA | www.acsm-healthfitness.org Copyright @ 2009 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited. VOL. 13/ NO. 3 companies, a medium-sized company partnering with its health plan, a large multinational corporation focusing on productivity, and a corporation interested in understanding how to optimize the influence of environmental characteristics on the health of their employees. BY WHO, FOR WHOM? This book reflects the collaboration of nearly 100 practitioners, academicians, scientists, and leaders from Canada, Europe, and the United States. In bringing the talents and insights of these contributors together, the book presents a comprehensive and contemporary look at the field of worksite health. As the title suggests, this book is an American College of Sports Medicine resource and, as such, has gone through a rigorous review that adds confidence to the credibility of the text. In addition, the book is endorsed by the International Association for Worksite Health Promotion (IAWHP). The IAWHP has VOL. 13/ NO. 3 been introduced to the field as a new ACSM affiliate society in late 2008, and this new text represents one of the early efforts of IAWHP to provide high-quality resources, education, and professional services to the global community of worksite health promotion practitioners. For more information on IAWHP, refer to the IAWHP Web site at www.acsm-iawhp.org. This book has the practitioner in mind as its primary audience. However, as the content describes not only the implementation processes and issues to consider but also the background, history, and context, it is likely that students, administrators, researchers, and teachers will find it useful as both a professional resource or a supplemental text. Enjoy! Reference 1. A guide to building healthy and productive companies. In: Pronk NP, editor. ACSM’s Worksite Health Handbook, Second Edition. Champaign, (IL): Human Kinetics; 2009. Nico Pronk, Ph.D., FACSM, FAWHP, is executive director of the Health Behavior Group and vice presid e n t of H ea l t h a nd Disease Management at HealthPartners health system, which provides health promotion, disease prevention, and disease management services for worksites and health plans around the country. Dr. Pronk has published extensively in the health-related scientific literature and is currently an associate editor for ACSM’s Health & Fitness JournalÒ and an Editorial Board member of the U.S. Centers for Disease Control and Prevention’s Preventing Chronic Disease e-journal. Among other public services activities, he currently serves on the Task Force on Community Preventive Services supported by the U.S. Centers for Disease Control and Prevention and the Interest Group on Worksite Health Promotion at ACSM. Dr. Pronk received Fellow status from ACSM and the former Association for Worksite Health Promotion. ACSM’s HEALTH & FITNESS JOURNALA Copyright @ 2009 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited. 45