Effective Small Business Wellness (workshop)

Build it and They Will Come: Launching an Effective Program for Small and Medium Size Companies

FacilitatorDr. Joel B. BennettOrganizational Wellness & Learning Systems

© 2009; Organizational Wellness & Learning Systems, Inc.—www.organizationalwellness.com

2010 WELLNESS SYMPOSIUMStrategies for Companies &Communities to Impact Health in A Changing Economy

WORKSHOP OUTLINE

• This workshop is designed to create collaborative problem solving for participants around a hypothetical scenario (See Part 4) to create a small business wellness initiative in the community.

• Participants are assigned to tables for diversity of composition (employees, employers, providers, insurers, non-profits).

• The room also has experts from the community available for consultation.• The goal is to identify key elements and strategy needed to launch an

effective community-based wellness initiative that supports small businesses.

• This full-day workshop was conducted at the Houston Wellness Association in January of 2010 with about 30 participants

• This is PART 1 of the slide deck; PART 2 reviews the results of the grant-funded Small Business Wellness Initiative (www.sbwi.org)

• Please contact OWLS at [email protected] if you would like technical assistance or training on how to conduct this workshop and launch an SBWI in your community

Other Presenters

• Olivia M. Dear, DirectorTexHealth Harris County 3-Share Plan (Harris County Healthcare Alliance)

• Ashly Alberto, Corporate Market Director, Houston Heart Walk, American Heart Association

• Sebabi Leballo, Organizational Development Manager, HCSS, Construction Software & Services

• Daniel Francik , Corporate Ambassador HCSS, Construction Software & Services

Participants (YOU): Which best describes you?

EMPLOYEES

EMPLOYERS or their representativeA. Very Small Business Owner/Employee-

less than 100 employees (not wellness provider);B. Small Business Owner

100 to 500 employees (not wellness provider)C. Small to Medium

larger than 500 employees (not wellness provider)

PROVIDER (Wellness Practitioner)

INSURERCORPORATE Representative

NON-PROFIT agency

Each table has good representation?

Key Elements

LAUNCH

PAD

Workshop Segments

Small BusinessWellness Program

What we mean by “SMALL” businesses

These data refer to the first quarter of 2004, downloaded from the BLS Quarterly Census of Employment and Wages (QCEW) website http://www.bls.gov/cew/ (accessed June 2005).

26%87%46%11%

1% 24%

Why Small Business? Top Ten Reasons

1. SBs significantly less likely to do Health Promotion* 2. SBs are 99% of all employers, w/60% of workforce3. Have generated 60% to 80% of net new jobs4. Employ majority of workers in a given community5. Sickness absence impacts work (replacement issues)

6. 1 person has more social modeling (CEO-ripple effect)

7. With less insurance, prevention more important8. Many SBs have positive work culture to leverage9. Entrepreneur/CEOs have humanitarian motives10. Promising practices exist (CDC SWAT study)* Healthy People 2010 targeted 75% businesses to receive wellness, but <50% do so and

some indication this is declining

More on the Insurance Problem

• The principal barrier to small businesses in Texas offering employer-sponsored health insurance is affordability.

• Recent US Census reports indicate that 1:3 Harris County non-elderly adults are uninsured; almost a quarter of the state’s population.

• Two-thirds of uninsured adults are employed, with 44 percent working at firms that employ less than 25 workers.

• Small business employers who depend on health insurance to attract and retain workers are finding it hard to find cost-effective insurance for their employees.

Part 1: What are SBs doing?(norms and trends)

SIZE MATTERS

Society of Human Resource Management 2009 Benefits Survey (% offering benefit)

On-site fitness classes

Health care premium discount for annual HRA

Stress-reduction program

Rewards/bonuses for achieving wellness goals

Health Fairs

Health Screening

Weight Loss

Health & Lifestyle Coaching

Smoking Cessation

Wellness Newsletter/column

On-site vaccinations

Wellness Programs

Wellness Resources/Information

0 10 20 30 40 50 60 70 80 90

2

4

5

14

19

19

21

24

26

27

39

46

60

11

9

11

23

45

39

29

32

39

43

68

58

72

26

14

18

30

68

54

40

43

51

52

84

73

82

Large (500+)

Medium (100-499)

Small (1-99)

3,000 HR managers randomly selected from 250,000—www.shrm.orgISBN 978-1-586-44155-5—SHRM 2009 Employee Benefits Report

Selected Programs compare with National Survey

On-site fitness classes

Health care premium discount for annual HRA

Stress-reduction program

Rewards/bonuses for achieving wellness goals

Health Fairs

Health Screening

Weight Loss

Health & Lifestyle Coaching

Smoking Cessation

Wellness Newsletter/column

On-site vaccinations

Wellness Programs

Wellness Resources/Information

0 10 20 30 40 50 60 70 80 90

2

4

5

14

19

19

21

24

26

27

39

46

60

11

9

11

23

45

39

29

32

39

43

68

58

72

26

14

18

30

68

54

40

43

51

52

84

73

82

Five Areas to be Compared

2

5

14

19

21

26

11

11

23

39

29

39

26

18

30

54

40

51

0 10 20 30 40 50 60

On-site fitness classes

Stress-reduction program

Rewards/bonuses for achievingwellness goals

Health Screening

Weight Loss

Smoking Cessation

Large (500+)

Medium (100-499)

Small (1-99)

Note. Gym membership is

30% to 35%, NOsize differences

2004 national worksite health promotion survey

• Directed by “Healthy People 2010” Initiative• Random telephone survey• Worksites sample (not organizations)• Respondents “directly responsible for health promotion

or wellness” or “in-depth knowledge of these types of programs at the worksite”

• Sample size 730 (60% response rate compares with 19% rate in SHRM survey)

• Over-sampled small businesses (compares with more corporate focus of SHRM survey)

Linnan, L., Bowling, M., Childress, J., Lindsay, G., Blakey, C., Pronk, S., Wieker, S., & Royall, P. (2008). Results of the 2004 national worksite health promotion survey. American Journal of Public Health, 98(1), 1-7.

Comparing HR with those more familiarHR Personnel (SHRM) Providers (National Survey)

Focus on Small Businesses (2000, California)

67%

52%48%

46%

SafetyTraining

EmergencyTraining

HazardousMaterial

First Aid

SAFETYPROGRAMS

20% 20%18% 18%

ViolencePrevention

SubstanceAbuse

Prevention

StressManage-

ment

Counseling

BEHAVIORMANAGEMENT

12% 10% 10% 8%

SmokingCessation

CholesterolScreening

PhysicalFitness

Diet orWeight

Manage-ment

PHYSICALHEALTH

McMahan, S. Wells, M., Stokols, D., Phillips, K., Clitheroe, H. C., (2001, Summer). Assessing health promotion programming in small businesses. American Journal of Health Studies (17.4% Response Rate)

1,846 Small Businesses Surveyed (sizes 2-14, 15-99, 100-500)[Los Angeles and Orange counties, California]

The Smallest of the Small (looking at the smallest businesses across the three surveys)

Smoking Cessation

Weight Manage...

Health Screening

Stress Management

Fitness*

26

21

19

5

2

9

11

21

18

10

9

7

5

9

7

13

7

9

14

9

California (2-14)

California (15-99)

National (50-99)

SHRM (1-99)

For planning, targeting, and marketing small distinctions make a big difference

So what? There is promise . . .

• Need to pay more attention to the very small (< 50) as these are majority of establishments

• Essential to know who you are talking to:– Human Resources– CEO– Internal Wellness Champion

• Significant variation by industry• Safety may be a lever• Humanitarian outcomes (rather than financial) may be more

important *– Genuine concern for well-being of employees– Improve the quality of their life

• Small businesses can do comprehensive programs* Divine, R. L. (2005). Determinants of small business interest in offering a wellness program to their employees. Health Marketing Quarterly, 22(3), 43-58.

Part 2

Many Methods are

Available

Strategy is a critical

Strategic Elements of the Launch Pad

Individual Health

EnvironmentTeam/Support

CEO/Mgr Engagement

Organization (Policy)

External Support& Community

Integration

© 2009; Organizational Wellness & Learning Systems, Inc.—www.organizationalwellness.com

IndividualHealth

Environment/Team Support

Organizational (Policy )

CEO Engagement

External SupportCommunityIntegration

Awareness CommunicationActivity CampaignsProgram EffortsBehavior Change

Wellness Culture

Strategy Matrix for Small Business Wellness Planning

IndividualHealth

Environment/Team Support

Organizational (Policy )

CEO Engagement

External SupportCommunityIntegration

AwarenessCommunication

• HRA• Email • Newsletters

• Posters• Climate survey• Readiness survey

Wellness is written into policy; e.g., no-smoking

Needs assessment with CEO

1. Align with insurance (plan, carrier, broker)

2. Set-up cooperative or local initiative

3. Local agencies• Public health• SBDC• non-profit

4. Local healthcare provider

5. Engage Local wellness biz

6. Community participation (Run for the cure)

ActivityCampaigns

• Walking / pedometer• Weight Loss

• Team activities• Free access to

exercise• Walking club

• Wellness committee• Empower to develop own resources

CEO participates with the team; lead by example

ProgramEfforts

• Coach outreach• e-health • Physician links/SBIRT

• Social marketing• Team wellness• Classes• Social networking

• Incentives• Disincentives• Work-life policy

Annual culture survey part of manager performance

Behavior Change

• Coach follow-up• Evidence based practices

• Reward tie behvior• Design effort-rwrd balance; job strain

Integrate wellness into performance goals

CEO transparency: CEO demonstrates behavior change

Wellness Culture

• Include culture survey with every HRA

Cultural touch-points (see Judd Allen)

• Rituals/calendar• Wellness vision statement• Act on

1. Local CEO roundtable2. Support non-profits3. Host events/fund raisers4. Healthy leadership campaigns

© 2009; Organizational Wellness & Learning Systems, Inc.—www.organizationalwellness.com

PART 3

SOLUTIONS AND BEST PRACTICES

Solutions & Best Practices

• START: FIT FRIENDLY (Walking Challenges)• TEXHEALTH HARRIS COUNTY 3-SHARE PLAN

(Accessing Community Healthcare/Insurance)• WORKPLACE WELLNESS

‘LIVE UP TO YOUR FULL POTENTIAL’(HCSS-Heavy Construction Systems Specialists)

• SMALL BUSINESS WELLNESS INITIATIVE(Evidence-Based Health Promotion)

PART 4

SCENARIO

Scenario

• Harris County (towns, cities) identified as 1 of 20 areas in the country to receive a Phase I challenge grant (cooperative agreement) for $2 Million

• 8 counties/areas will move to Phase II (10 years; $5M)

• Three years to demonstrate:1. Can match the $2M with private & public monies2. Deliver health promotion to 100 small businesses that have not

received services (industry, diversity, health disparities)50 of these with less than 50; 25 w/51 to 100; 25 w/ 100+

3. Demonstrate Insurers and SB CEO collaboration w/community4. Programs in place for at least 1 year with demonstrable outcomes

in four areas– Behavior change (health improvement)– Environmental and/or culture change– Policy changes are effective– CEO engagement

References• Barbeau, E., Roelofs, C., Youngstrom, R., Sorensen, G., Stoddard, A., & LaMontagne, A. D. (2004).

Assessment of occupational safety and health programs in small businesses. American Journal of Industrial Medicine, 45, 371-379.

• Brissette, I., Fisher, B., Spicer, D. A., & King, L. (2008). Worksite characteristics and environmental and policy supports for cardiovascular disease prevention in New York State. Preventing Chronic Disease, Public Health, Research, Practice, and Policy, 5(2), 1-12.

• Divine, R. L. (2005). Determinants of small business interest in offering a wellness program to their employees. Health Marketing Quarterly, 22(3), 43-58.

• Eakin, J. M., Cava, M., & Smith, T. F. (2001). From theory to practice: A determinants approach to workplace health promotion in small business. Health Promotion Practice, 2(2), 172-181.

• Linnan, L., Bowling, M., Childress, J., Lindsay, G., Blakey, C., Pronk, S., Wieker, S., & Royall, P. (2008). Results of the 2004 national worksite health promotion survey. American Journal of Public Health, 98(1), 1-7.

• Hunnicutt, D. Big steps for small businesses: The art of implementing a great wellness program in a small business setting. Absolute Advantage, The Workplace Wellness Magazine, 7(2), 3-44.

• McMahan, S., Wells, M., Stokols, D., Phillips, K., & Clitheroe, H.C., Jr. (2001). Assessing health promotion programming in small business. American Journal of Health Studies, 17(3), 120-128.

• McPeck, W., Ryan, M., & Chapman, L. S. (2009). Bringing wellness to the small employer, American Journal of Health Promotion, 23(5), 1-10.

• Society for Human Resource Management (SHRM). (2009). Employee benefits: Examining employee benefits in a fiscally challenging economy. Retrieved INSERT DATE, from www.shrm.org/surveys.