Inside HealthFitness
HealthFitness Attains NCQA Wellness & Health Promotion Accreditation
HealthFitness received Wellness & Health Promotion Accreditation from the National Committee for Quality Assurance (NCQA), a private, non-profit organization dedicated to improving health care quality, this December.

NCQA Wellness & Health Promotion Accreditation is a nationally recognized evaluation that purchasers and consumers can use to assess wellness and health promotion programs. NCQA Wellness & Health Promotion Accreditation comprehensively evaluates key areas of health promotion, including how wellness programs are implemented in the workplace, how services such as health coaching are provided to help eligible individuals develop skills to make healthy choices and how sensitive health information of eligible individuals is properly safeguarded.

NCQA Wellness & Health Promotion Accreditation standards are purposely set high to encourage wellness and health promotion organizations to continually enhance their quality measures. No other comparable evaluation exists for wellness and health promotion programs.

“HealthFitness works everyday to provide the highest level of service to the people we serve,” said Gregg O. Lehman, Ph.D., president and chief executive officer, HealthFitness.“We are proud that our programs and services to support and enhance employee health and well-being have met the standards for NCQA Wellness & Health Promotion Accreditation.”

For more information about NCQA, please click here.

Interested in Offering Health Coaching? Here’s What You Should Know
More than half (51 percent) of companies are planning no change or a slight increase to their health and productivity program budgets, according to the 2009 Staying@Work Report, a survey conducted by Watson Wyatt and the National Business Group on Health.

In addition, nearly three-quarters (72 percent) of employers have enhanced their on-site offerings with programs such as health coaching, or expect to do so in the next 12 months.

Why health coaches? Because effective health coaching works to help employees convert best intentions into action.

But not all health coaching programs are created equal.

If you are thinking about adding health coaching, Kelly Merriman, director of health coaching and worksite screening services at HealthFitness, recommends using the following criteria to ensure the health coaching partner you select can drive engagement and results with employee health:

1. Training. A results-driven coaching provider will require its coaches to have expertise in behavior change as well as in coaching disciplines and techniques. They will provide ongoing training to ensure their coaches stay current with industry best practices.

2. Client-specific training. To build a supportive, trusting relationship with your employees, health coaches should be well-trained on your specific population, and understand the company’s culture. The coaches must also know the other resources available, such as on-site Weight Watchers, a fitness center or Employee Assistance Program, so they can refer employees when appropriate.

3. Quality assurance. A health coaching partner committed to quality will review coaching sessions on an ongoing basis to evaluate the effectiveness of individual coaches and the overall team of coaches, and to identify opportunities for training with staff.

4. National Committee for Quality Assurance (NCQA) certification. NCQA is a not-for-profit organization dedicated to improving health care quality. A company with the NCQA certification is required to keep their coaches’ skills up to date. Plus, NCQA certification shows the organization is willing to go the extra mile to ensure they adhere to best practices.

5. Metrics. You shouldn’t have to wait a full year to learn whether the health coaching program is making an impact. Ask if they have quarterly reports available to monitor participants’ progress with achieving their health goals.

6. Multiples means for communication. Not all participants like to be coached via telephone. Some feel more comfortable communicating via the Web; others prefer face to face. Be sure the health coaching provider can interact with your participant in multiple formats.

7. Information and resources. While health coaching helps participants move forward with their desired lifestyle changes, they also need access to evidence-based resources and information. Does the health coaching provider include what participants need to know in terms of choosing healthy foods, becoming more active, losing weight, managing stress or quitting smoking?

Interested in learning more about the value of health coaching or how to select a health coaching partner that is right for you? Contact your program manager.

Best-in-class Practices and Awards
Why Focusing on Employees Who Don’t Want to Change Makes Good Business Sense
By HealthFitness Chief Medical Officer Jim Reynolds, M.D.

Changing human behavior is not an easy task.

For this reason, it makes sense that most employee health programs focus on the low-hanging fruit of helping those who are ready to make changes. However, taking this approach leaves a significant percentage of high risk individuals behind.

Those in the health industry are familiar with the term “stages of change.” This model proposes a series of stages that a person goes through when making permanent behavioral and lifestyle changes.

These stages involve:

1. Pre-contemplative/unaware

2. Contemplative

3. Preparing

4. Action/trying

5. Maintaining

In the stages of change model, those who are not ready to change are called pre-contemplative or contemplative. In pre-contemplative, people can’t see the need to change and have no intention of doing anything differently. In the contemplative stage, people start to think about an issue and the possible need to make some changes.

People in these two stages are often overlooked in current employee health programs, in lieu of providing support to those who are already “preparing” to take action. Yet, employers also have a vested interest in engaging the pre-contemplative and contemplative in reducing health risks because of the dramatic influence these employees can have on health care costs.

Consider the impact of this population with a hospital client, for example. This client’s 2009 aggregate health risk assessment data shows that 314 employees are at high risk for physical inactivity and 184 employees are at high risk for obesity. These employees also report a low readiness to change. The estimated excess health care costs associated with just these 498 employees—of its nearly 8,700 eligible population—is more than $745,000.

So what does it take to motivate those who aren’t yet ready to improve their health?

Research shows several strategies can be effective in moving pre-contemplative and contemplative participants closer to taking action. And to help our clients target these employees, HealthFitness will launch an innovative program in 2010 designed to move this population to the next stage.

We look forward to sharing details in the coming year, and to continuing to deliver additional innovative solutions that further engage your total population in better health.

Effectively Motivating Employees to Participate in Fitness with Innovative Programming
HealthFitness partners with employees of Dow Jones, a large financial publisher, to reinforce that health is wealth—and thanks to innovative programming offered at the site, company employees regularly invest time to be physically active.

At Dow Jones’s South Brunswick, N.J., location, HealthFitness manages the company’s 8,000-square-foot fitness facility, which provides group exercise classes, a kids’ fitness program and summer camp, and recreational programming.

To keep the company’s roughly 500 members involved and motivated, HealthFitness Program Manager Lisa Tatulli and staff provide a variety of creative programs. These include:

• Group Exercise Word Puzzle, where participants receive a letter for each class they attend and the first person to solve the puzzle wins Six Flags amusement park tickets

• An annual “indoor triathlon” that includes three weeks of intensive cross-training involving running, rowing and biking

• Mother’s and Father’s Day programs, where each day during the week leading up to the holiday, group exercise participants are entered into a raffle to win daily prizes such as bracelets and gift cards to sporting goods stores

• 30-minute circuit training classes to help busy employees find time to exercise

• Free healthy breakfasts (providing yogurt, cereal bars and other items) before morning classes

• Healthy Check program, where members who achieve 10 visits per month for two consecutive months and also have their blood pressure and weight checked earn a free lunch voucher at the company’s cafeteria

Through employee feedback, it’s clear the mix of programs as well as the camaraderie and support offered by HealthFitness staff is positively affecting employee health.

One employee, for example, texted Tatulli: “I am at my doctor’s office right now for a follow up visit for my blood pressure, which was borderline high last visit. Good news. Pressure is super normal and I’m 18 lbs lighter since last visit! All blood work is that of a typical 30 year old. Doctor is amazed. Last visit was four months ago!”

Another employee shared: “Having a health club on-site has helped me tremendously. I would never have had time to go to an offsite gym to keep the workout schedule going. I have definitely seen my workouts improving and it’s one of the reasons I don’t like taking days off. Within a year I lost my mother and my brother due to heart attack. The health club helped me physically and emotionally to get back on track.”

HealthFitness has managed the Dow Jones Health Club since 1999.

How Employers with Tight Budgets Drive Employee Health
In light of tight budgets, employers committed to employee health are finding creative ways to continue programming. In Colorado, for example, two technology companies combined funding to keep an on-site fitness center open for employees.

In Fort Collins, a supplier of computers, printers and laptops, and Avago, a supplier of analog interface components for communications, industrial and consumer applications, share a wellness program for their employees. The two employers are located in the same building.

The supplier of computers has 2,000 eligible employees; Avago has 600. The partnership between the supplier of computers, Avago and HealthFitness began in the fall of 2007. The fitness center currently has 815 members.

To help cover expenses, members pay for group exercise classes and during the past two years, both participation and the number of group exercise classes have grown. Examples of classes offered through the site include yoga, Pilates and muscle pump.

“Because of a limited budget, our site has also learned ways to create a connection within the community to find support,” HealthFitness Program Manager Ashley Schwader said. “Community restaurants, for example, donate bagels for our 5K races and give us gift certificates to raffle off to participants as a way to drive participation.”

Schwader is also creative in generating health promotion programs the site offers, including a Push Up Crunch challenge that required members to pay $2 to participate. This money was then used to purchase prizes for the winners. Other programs that keep health on the forefront of employees’ minds include two 5K races, a one-mile race and Maintain Don’t Gain, a holiday weight maintenance program. Employee testimonials from those who use the fitness center reinforce the impact it is having on their health and well-being.

“As a fair-weather athlete it's easy to slack off and let the pounds add up only to have to work twice as hard to get them back off when the weather becomes fair again. This year's ‘keep your weight off’ program will definitely help me stay the course and help me keep my weight in mind daily,” said Steve Douglas, an employee with the supplier of computers.

Jamie Rubin of Avago added, “What I like best about having the wellness facility right on-site is—providing motivation! The holiday weight control contests help me pay closer attention to weight control during the holiday season. Without this motivation I was one who seemed to always put on a few extra end-of-the-year pounds.”

Industry Insights
Buzz from Recent Research
New Report Finds Only 25 Percent of Adults Aged 50-64 Get Recommended Preventive Screenings
Only about one in four Americans aged 50–64 regularly take advantage of preventive services such as screenings and immunizations, according to a report from the Centers for Disease Control and Prevention in collaboration with AARP and the American Medical Association.

The report, “Promoting Preventive Services for Adults 50–64: Community and Clinical Partnerships,” focuses on opportunities to improve the health of the growing number of adults in the 50–64 age bracket to broaden the use of potentially lifesaving preventive services.

By 2015, an estimated 63 million U.S. adults will be between the ages of 50 and 64, comprising 20 percent of the nation′s population. This population is at greater risk of developing chronic diseases such as heart disease and cancer than younger adults. Almost one–third of adults in this age group are uninsured or underinsured, which heightens the challenges of ensuring they receive critical preventive services.

Source: Centers for Disease Control and Prevention, http://www.cdc.gov/media/pressrel/2009/r091119a.htm, accessed Dec. 1, 2010.

Good and Bad News for Cholesterol
A study in the Journal of the American Medical Association recently reported mixed news with cholesterol levels in U.S. adults. The study reported that between 1999 and 2006, the number of adults with high levels of LDL cholesterol, also called “bad” cholesterol, decreased by about one-third. However, researchers also found that a high percentage of adults are not being screened or treated for high cholesterol levels.

Researchers looked at the data from more than 7,000 adults from the National Health and Nutrition Examination Survey (NHANES) to study trends in the prevalence of screening, current use of cholesterol-lowering medication, and high LDL-cholesterol levels across four study cycles: 1999-2000, 2001-2002, 2003-2004, and 2005-2006.

The prevalence of high LDL cholesterol levels decreased from 32 percent to 21 percent between 1999 -2006. However, the prevalence did vary significantly by risk category. In 2005-2006, the prevalence of high LDL cholesterol was 59 percent, 30 percent, and 11 percent in the high-, medium- and low-risk groups, respectively. Furthermore, in the high-risk group, close to 40 percent were untreated or undertreated for high cholesterol and more than 35 percent had not been screened for high cholesterol in the last five years.

Source: Kuklina, EV, Yoon, PW, Keenan, NL. Trends in High Levels of Low-Density Lipoprotein Cholesterol in the United States, 1999-2006. The Journal of the American Medical Association. 2009;302(19):2104-2110

Health Care Reform Update: House Passes Bill; Senate Begins Debate on its Version
On Nov. 7, 2009, the U.S. House of Representatives passed the Affordable Health Care for America Act by a vote of 220 to 215. This legislation would create a wellness grant program to assist small employers with the creation of employee wellness programs. The wellness grants would be provided to small employers for up to three years to pay for up to 50 percent of the costs incurred for a qualified wellness program.

On Nov. 18, Senate Majority Leader Harry Reid unveiled the Senate’s health care reform proposal, the Patient Protection and Affordable Care Act. This legislation would allow employers to offer premium discounts and other awards of up to 30 percent of the cost of coverage to individuals who participate in a wellness program and meet certain health-related standards. The Secretaries of Labor, Health and Human Services, and the Treasury may increase the reward to up to 50 percent if they determine that such an increase is appropriate.

The Patient Protection and Affordable Care Act would also require the Centers for Disease Control and Prevention to study and evaluate best employer-based wellness practices and provide an educational campaign and technical assistance to promote the benefits of worksite health promotion to employers.

On November 21, the Senate voted 60 to 39 to begin debate on the Patient Protection and Affordable Care Act. The full Senate is now considering the legislation. A date when the final vote will occur is currently unknown.