Employee Lifestyle Change Wellness Programs: Big Gains for Little Investment

By Bob London, ALED Facilitator, Diabetes and Wellness Foundation, bobl@rmlondon.com;
Kara Yaeger, UW Hospitals & Clinics, RN/Cert. Diabetes Educator, ALED Facilitator

The Problem

Extensive exercise, medical, and psychosocial research over the past 20 years has shown that small amounts of exercise and healthy eating can reduce the risk of cardiovascular death, diabetes, some cancers, high blood pressure, obesity, and stress by as much as 50%. Conversely, daily exercise and healthy eating can build bones, enhance your immune system, reduce stress and depression, aid in weight management, and promote self-esteem. Longitudinal research studies, such as the Diabetes Prevention Program and Project Active, involved over 40,000 people and resulted in the U. S. Surgeon General, Centers for Disease Control and Prevention, and the American College of Sports Medicine recommending that we do 30 minutes of moderate-intensity activity daily to improve health and maintain fitness. Unfortunately, 60 percent of Americans are not exercising enough, and 25 percent are not active at all.

The Need for Lifestyle Change Programs

So, something as simple as 30 minutes a day of exercise and watching what you eat can help you keep you healthy and fit. But, at least half of us out here don't do it! Why? There are a few reasons why most of us don't exercise daily and eat right. Main reasons for poor lifestyles include: (1) jammed packed, over-extended lifestyles with work, family, and community obligations, (2) lack of information about how to have healthy lifestyle, (3) "healthy-lifestyle-sabotaging-attitudes", and (4) "couch-potato-syndrome". We are a society that is learning how to "watch" rather then "do".

Wellness and lifestyle change programs help sedentary people overcome self-defeating behaviors and attitudes by teaching healthy exercise, eating, and psychosocial behaviors. Notice the last term "psychosocial". Lifestyle wellness programs are not just exercise programs. Telling someone to exercise will not work. Showing someone how to exercise will not work. Buying a membership to a health club often ends up sitting in our wallet and goes unused. What makes lifestyle change wellness programs unique is that they use research-based, cognitive-behavioral change techniques to help sedentary people develop decision making, coping, attitude, and self-belief skills that are necessary to facilitate durable, long-term, exercise and eating behavior lifestyle changes.

Reduce Your Medical Costs

Many corporations and insurance companies are starting to directly address the economic burden of pre-diabetes and diabetes, and recognize the economic benefits that wellness programs can have on reducing medical costs. Work site health promotion and disease management programs reduce absenteeism, maintain productivity, reduce sick leave, reduce hospital visits, and reduce medical benefits costs. Total healthcare claims are estimated to exceed $12,000 per employee in 2006. Over 50 percent of those costs will be lifestyle related. Corporations such as Travelers, Johnson & Johnson, Inc., Citibank, and Coors have documented their medical and insurance savings from wellness programs that run into the millions. Estimated savings in heath costs range from $3-$5 return for every dollar invested in a wellness program. Some estimates suggest that these programs can reduce the costs of chronic illness up to 60%. The real issue is not whether wellness or psychosocial-educational programs should be implement, but rather how such programs should be designed, implemented, and evaluated.

Elements of a Lifestyle Change Program

Lifestyle change programs can be developed and run in-house, or can be run by certified wellness facilitators. A good program should target measurable improved outcomes such as weight loss, decreased blood pressure, increased fitness in realistic exercise levels, decreased heart rate, or improved glycemic control if employees are diabetic. The length of program should be 16-20 weeks, with weekly evaluations done by the participants. Behavior and attitude change takes time, and the program is a collaborative process.

Successful lifestyle programs: (1) do rather then lecture, (2) empower participants to discover what works for them, (3) allows participants to move at their own pace, (4) has a strong self-monitoring component, and (4) provides support via email coaching or phone coaching throughout the program. The "teaching-by-doing" approach directly engages the participant. In addition to focusing on mild exercise and eating lifestyle behavior modification, a comprehensive program must explore barriers to lifestyle changes, build decision skills, coping skills, relapse prevention skills, stress management skills, and time management skills.

Costs and Co-sponsoring a Program with Your Insurance Company

A lifestyle program usually costs about $200 per participant to run. Many lifestyle programs, if properly constructed and documented will qualify for wellness benefit reimbursement upon completion from your medical insurance company. For this reason, it is valuable to contact your insurer ahead of time and work with them to develop and implement a program.

Getting a Program Started

Getting a program started usually requires developing a proposal for approval and budgeting. Within the proposal you may want to describe the (1) curriculum, (2) target audience, (3) program goals, (4) budget, (5) qualified facilitators, (6) location and program times, (7) marketing, (8) outcome measures for success determination, (9) program development timeline, and (10) program implementation timeline and task list.

Lastly, by time 20 weeks is over, you can expect to learn a lot from your class participants, and in return helped many in the class be a little fitter and healthier. Hopefully, it's the simple things in life we do that have the most benefit, and end up being what we value the most.

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