These learning resources will also be helpful in informing the background and proposed steps sections of the Briefcase Project.  I like how both the HERO scorecard and the CDC Worksite Health ScoreCard help a company get a sense of where they’re currently at and how they stack up against other companies; without this context, it’s impossible to plan for next steps.  In particular, it’s interesting that the CDC’s ScoreCard has been updated with questions about four health issues that are emerging as significant risk factors for an employee population: cancer, alcohol and other substance use, sleep and fatigue, and musculoskeletal disorders, in addition to heart disease, stroke and other risk factors.  That being said, some of the materials do feel a bit repetitive, and I would like another source to examine health and wellness from an individualized perspective (such as The Wellness Checkpoint HRA at https://wellnesscheckpoint.com) rather than always from an entire population perspective.  Springbuk, however, does a great job of providing analytical data that helps examine trends and costs from a specific population perspective (i.e. how much employees with diabetes cost versus employees with cancer).  

I’m looking forward to learning about other great resources that could be utilized, particularly other toolkits that have been effective in the past.  I know we’re all familiar with Welcoa’s Seven Benchmarks for successful programs; this resource is effective because it breaks down each section into a toolkit that can help employers drill down in areas that need the most help or support.  The CDC also links to other great resources on a federal and state level, and I love how Tufts Health has created a guide of free resources for small businesses to utilize.  

In particular, the concept of TWC seems quite aligned with the social ecological concept of health, which stresses that we cannot look at individual health outcomes without examining the social and physical environments that shape patterns (Women and Children Health Policy Center (WCHPC), 2014).  TWC is built on the concept that work is a social determinant of health, and “job-related factors such as wages, hours of work, workload and stress levels, interactions with coworkers and supervisors, access to paid leave, and health-promoting workplaces all can have an important impact on the well-being of workers, their families, and their communities” (CDC, 2017).  The social ecological model expands on this, looking at health from all angles ranging from the individual, interpersonal relationships, institutional support, community influence and policy influence.  It’s evident that both models challenge wellness practitioners to go beyond the obvious (i.e. “this person is obese and can’t lose weight”) and seek out the underlying reasons why things may be the way they are (i.e. an obese person may hold certain values around food and exercise, may be influenced by their families and friends, may not have access to healthy food at work or school, may not have affordable or safe options for exercise, and may be under the influence of policies that negatively impact weight).

The area of interpersonal influence really stands out in the videos about the hidden influence of networks.  I was shocked to hear that if you have a close friend who becomes obese, you have a 57% greater chance of becoming obese too (Christakis, 2010).  Wellness program managers will want to understand the implications of social networks in depth, particularly because the workplace is an excellent example of a community that can influence health outcomes.  While norms and habits spread through social networks, it’s imperative to remember that positive effects can spread just as easily as negative ones; for example, if wellness managers can tap into wellness champions to spearhead walking breaks instead of smoking breaks, social networks can be used for change for good.  This even applies to people in your life you only see occasionally! We are so interconnected that if you lose weight and your good friend, who perhaps you only see annually, takes note, they are much more likely to do the same (Fowler, 2010).

In terms of developing a tool or plan to assess a worksite, keeping these factors in mind, it would require getting a baseline understanding of all aspects of individuals and the organization, including surveying people about their own health-related values and beliefs, understanding the social/cultural and institutional aspects as play, such as how colleagues are interacting around health goals and how the company supports said goals, and assessing the efficacy of company-wide health policies to determine what areas need the most attention and change.  I would recommend choosing top priorities in each area to focus on while tapping into the power of the workplace community, bringing colleagues together to motivate and positively influence one another, to move towards positive change.  These concepts are incredibly helpful to keep in our briefcase and to bring to the capstone course, though depending on the question at stake and the project objective, I can see some aspects of these resources being more impactful than others.  I have a feeling that the Social Ecological model will be incredibly important for projects focusing on a culture of health, for example, whereas the social networks theory could be more impactful for employee engagement initiatives.

References:

Centers for Disease Control and Prevention. (2017). What is total worker health? Retrieved from

https://www.cdc.gov/niosh/twh/default.html 

Christakis, N. (2010, February). The hidden influence of social networks [Video file]. Retrieved

from

Fowler, J. (2010, March 17). James Fowler: Power of networks [Video file]. Retrieved from

Women and Children Health Policy Center (WCHPC). (2014, September 11). An introduction to

the ecological model in public health [Video file]. Retrieved from https://www.youtube.com/watch?time_continue=3&v=Rm00AzC-gEU

The learning resources provided through our program were helpful, especially in developing the subcategories for employee engagement mentioned above.  In particular, I found the toolkits and the scorecards the most helpful in figuring out which categories would be necessary to include when evaluating employee engagement, as well as the studies and information from Optum Health and Willis Towers Watson.  For example, I knew that I wanted to include both a culture of health and managerial support as a subcategory because according to Robinson (2013), employee engagement affects a future well-being culture and change, and management can play an impactful role in keeping engagement high and culture alive and well.  I also felt it was important to include engagement strategies, such as marketing techniques and incentives, since companies that have high engagement also tend to utilize a variety of these tactics, from competitions and challenges to wearable devices to devoted incentive strategies (Serxner, Sherrets, Kichlu & Ratelis, 2016).

References:

Robinson, J. (2013, March 19). How to create a culture of organizational wellbeing. Business Journal. Retrieved from http://news.gallup.com/businessjournal/159080/create-culture-organizational-wellbeing.aspx

Serxner, S., Sherrets, D., Kichlu, R., & Ratelis, E. (2016). The five keys to building a culture of health. Retrieved from https://www.optum.com/content/dam/optum3/optum/en/resources/white-papers/COH.pdf

Employee engagement is incredibly important for a multitude of reasons, one of the main ones being the financial implications for a company.  According to Osborne & Hammoud (2017), “disengaged employees typically cost U.S. corporations $350 billion annually” and the engagement levels of employees affects the overall productivity of the organization.  Motivated employees tend to have higher job satisfaction, and employees with positive emotional states are also more motivated (compared to employees who are withdrawn, defensive, or disengaged), resulting in higher performance (Osborne & Hammon, 2017).  Employee engagement is also associated with companies who have a positive organizational culture, where the focus is on rewarding employees and creating an environment for people to develop and thrive (Parent & Lovelace, 2015).

Given this brief overview, this project seeks to answer the question: how can an organization with a strong culture of wellness capitalize on internal programming to motivate employees to increase employee engagement and effectiveness?  I want to find out how companies with an existing culture of health can better utilize this culture to increase overall employee engagement and effectiveness in the workplace, and I hope to determine some of the best practices to help build engagement into an existing wellness program.  The purpose of this investigation is to determine what other levers need to be pulled to increase employee motivation and positivity to create a higher performance culture.

If the question being investigated is answered, the benefits could include: increased productivity, less resistance to organizational change, increased motivation to perform, increased revenue, and decreased attrition.  According to Reilly (n.d.) engaged employees are rare; only 33% of employed Americans are engaged at work, and creating a strategy to tap into the remaining 67% offers a business the greatest opportunity to improve performance and profitability for long-term growth.

Osborne, S., & Hammoud, M. S. (2017). Effective Employee Engagement in the Workplace.

International Journal of Applied Management and Technology,16(1), 50-67.

doi:DOI:10.5590/IJAMT.2017.16.1.04

Parent, J. D., & Lovelace, K. J. (2015). The Impact of Employee Engagement and a Positive

Organizational Culture on an Individual's Ability to Adapt to Organization Change.

Retrieved from http://scholarworks.merrimack.edu/mgt_facpub/10

Reilly, R. (n.d.). Five Ways to Improve Employee Engagement Now. Retrieved from

https://www.gallup.com/workplace/231581/five-ways-improve-employee-engagement.aspx

Employee Engagement: The Key to Improving Performance
http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.466.1591&rep=rep1&type=pdf

Effective Employee Engagement in the Workplace: https://scholarworks.waldenu.edu/cgi/viewcontent.cgi?article=1239&context=ijamt

The Impact of Employee Engagement and a Positive Organizational Culture on an Individual’s Ability to Adapt to Organization Change
https://scholarworks.merrimack.edu/cgi/viewcontent.cgi?article=1009&context=mgt_facpub

Employee Engagement: A Review Paper on Factors Affecting Employee Engagement

https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-016-3843-x

Employer Wellness Initiatives Grow, But Effectiveness Varies Widely
http://www.hpci.org/documents/Employer-Wellness-Programs.pdf

https://www.gallup.com/workplace/231581/five-ways-improve-employee-engagement.aspx

Can Positive Employees Help Positive Organizational Change? Impact of Psychological Capital and Emotions on Relevant Attitudes and Behaviors
http://digitalcommons.unl.edu/cgi/viewcontent.cgi?article=1031&context=managementfacpub

http://hrexecutive.com/engagement-through-wellness/

Creating a Successful Engagement Strategy with Dr. Susan David
https://connect.virginpulse.com/files/Creating_Successful_Engagement_Strategy_Dr_SusanDavid.pdf

The Three Leadership Tenets Behind a Strong Well-Being Culture
http://www.healthways.com/blog/2014/07/the-3-leadership-tenets-behind-a-strong-well-being-culture

How the Best Worksite Wellness Programs Change Behavior
https://www.wellsteps.com/blog/2018/01/01/best-worksite-wellness-programs/

https://www.quantumworkplace.com/future-of-work/10-ways-to-increase-employee-engagement-with-corporate-wellness-programs/

Self-Determination Theory

Michigan Health and Wellness 4x4 Plan to Commit to Fit! Partnership
https://gfhc.org/wp-content/uploads/2017/08/HEALTH-8C5A.2016.Version2.0.Final_.Workplace.Wellness.Toolkit.042116.na_.compressed.pdf

Engagment Toolkit for Managers and Leaders
https://hr.harvard.edu/files/humanresources/files/engagement_toolkit_leaders_managers.pdf

https://jasonlauritsen.com/2017/04/what-does-it-mean-to-make-work-human/

Two Key Guidelines for Maximum Employee Engagement
https://community.virginpulse.com/bj-fogg-guidelines-maximum-engagement-webinar-replay-thank-you

5 Strategies to Instantly Boost Employee Engagement Within Your Organization
https://connect.virginpulse.com/files/5_Strategies_to_Instantly_Boost_Employee_Engagement_Within_Your_Organization.pdf

Employee Experience Maturity Model
https://www.limeade.com/content/uploads/2019/01/Limeade_EmployeeExperienceMaturityModel.pdf?_ga=2.240266688.21495969.1551030869-286087565.1532125950

How to Design an Employee Engagement Survey
https://www.qualtrics.com/wp-content/uploads/2015/10/Qualtrics_EBook__How_to_Design_an_Employee_Engagement_Survey.pdf

Building A Culture of Health
https://www.rwjf.org/en/cultureofhealth.html/en/cultureofhealth.html

Developing Culture of Health Metrics That Really Matter to Companies and Communities
https://hero-health.org/wp-content/uploads/2016/04/HERO-Final-Report-Developing-Culture-of-Health-Metrics-That-Really-Matter-to-Companies-and-Communities.pdf

Some resources that have not been as helpful to me personally are the toolkits that are very specific to an organization or community; while I like to see and understand how wellness goals and objectives are implemented, measured, achieved and reworked, I find some of these examples to be lengthy and broad.  I would like to see more information around best practices for the proposed steps section of our project, including how to create a survey for engagement for example, how to execute on a strategy, and how to measure results.  A more holistic approach would be incredibly helpful as we continue along in this project, rather than more toolkits that are incredibly specific to a group or population of people.

Some resources that I’ve found helpful, particularly around my topic of employee engagement (which is another major topic that the course covers as well) include the following:

References:

Pronk, N. (2014). Worksite health promotion: Best practice design principles of worksite health

and wellness programs. American College of Sports Medicine, 18(1), 42-46.

 

Serxner, S., Sherrets, D., Kichlu, R., & Ratelis, E. (2016). The five keys to building a culture of

health. Retrieved from https://www.optum.com/content/dam/optum3/optum/en/resources/white-papers/COH.pdf

Willis Towers Watson. (2016). Improving workforce health and productivity: Connecting the

elements of workplace culture. Retrieved from https://www.willistowerswatson.com/en/insights/2016/04/2015-2016-staying-at-work-united-states-research-findings

The AMSO Model of Behavior Change is a simple model that “helps worksites create an effective wellness program that improves employee health” (Aldana, 2018).  This model focuses on building awareness, tapping into motivation to drive change, examining the skills needed to create change, and then the opportunities at an environmental and policy level to achieve change and find success (Aldana, 2018).  According to O’Donnell, simply looking having a wellness program focus on health risks is not nearly enough, because this will not spur actual change; instead, he urges employers to recognize their employees as whole people, and to encourage them to discover their passions and link said passions to their health (O’Donnell, 2010).  It is important for an organization to know how to tap into motivation to create behavior change and to bolster an internal culture of health, particularly because “the success of any well-being strategy depends on finding the triggers that prod employees to take action” (Willis Towers Watson, 2016).  Despite the fact that motivation is intrinsically driven, meaning employees have to possess the self-efficacy and motivational readiness to change, employers can make an impact by providing the “supportive environment, triggers, resources and recognition that prompt action” (Willis Towers Watson, 2016).

While the AMSO model suggests that opportunities are even more impactful than motivation (representing 40% of success for behavior change, compared to 30% for motivation), this tool as a whole will add significant value to me for my briefcase project.  Since my project is centered around employee engagement, it’s important for me to be able to make recommendations to my employer (where I will ideally be implementing my capstone project) on ways we can successfully build motivation via intrinsic motivators as well as extrinsic incentives, environmental design, and policies for a boost to overall employee engagement.  This tool provides indirect data around engagement, particularly around the importance of helping employees find what motivates them to subsequently help them change their behavior, how tailoring goals and programming will impact readiness to change and therefore overall success rates, and how environmental and policy updates to our existing wellness program could help achieve increased engagement in an existing culture of wellbeing (O’Donnell, 2016).  In general, the AMSO model of behavior change is incredibly simple and effective because it speaks to the ways in which both people and organizations can change behavior and change the culture that influences behavior.

References

Aldana. S. (2016, September 7). How the best worksite wellness programs change behavior

[Web log post]. Retrieved from https://www.wellsteps.com/blog/2016/09/07/best-worksite-wellness-programs/ 

O'Donnell, M. (2010). Changing behaviors: Dr. Michael O'Donnell presents a new way to think

about behavior change. Retrieved from https://www.welcoa.org/wp/wp-content/uploads/2014/06/newsviews_odonnell.pdf

Serxner, S., Sherrets, D., Kichlu, R., & Ratelis, E. (2016). The five keys to building a culture of

health. Retrieved from https://www.optum.com/content/dam/optum3/optum/en/resources/white-papers/COH.pdf

Willis Towers Watson. (2016). Improving workforce health and productivity: Connecting the

elements of workplace culture. Retrieved from https://www.willistowerswatson.com/en/insights/2016/04/2015-2016-staying-at-work-united-states-research-findings

Workplace wellness is approached differently nationally versus internationally.  According to the Global Wellness Institute (2016), international wellness programming has only emerged in emerging markets like Brazil, Mexico, China and Malaysia since the 1990s, compared to the 1940s in the United States, and “European employers have been slower to adopt formalized workplace wellness programs and EAPs, as such services have traditionally been provided by government sources”.  This is important to note, as many foreign governments provide programming for the health of their people compared to the U.S., where the burden is placed more on employers.  However, organizations like the European Union and the World Health Organization (WHO) have been working towards creating a holistic and comprehensive approach to workplace wellness through worldwide training and advocacy programs (Global Wellness Institute, 2016).  In the U.S., the majority of mid- to large-sized companies and multinational companies have workplace wellness promotion programs in place, but since workplace wellness was born out of the U.S., “where medical care is primarily paid for by employer-provided insurance, wellness programs typically focus on employees’ physical health, while employee assistance programs (EAPs) address mental health and other behavioral/lifestyle issues”, programs mostly aim to address a company’s overall healthcare spending and lower their costs due to illnesses and disabilities (Global Wellness Institute, 2016). 

Regardless of geography, type or size of company, employee demographics, or national vs. international or multinational companies, there are similarities in the goals and objectives of workplace wellness programs.  One major aspect is that all comprehensive programs go beyond simply exercise or physical health; for example, the European Network for Workplace Health Promotion DATE) focus on areas including lifestyles and aging, corporate culture, such as leadership, development, work-life balance, mental health, stress, Corporate Social Responsibility (CSR) and nutrition and health.   According to Deloitte University Press (2016), all organizations regardless of location, size or demographics must look at shifting the way organizations work as a whole, focusing on “understanding and creating a shared culture, designing a work environment that engages people, and constructing a new model of leadership and career development.”   While no organization will go about impacting the many aspects of wellness and shaping their company culture in the same way, it’s important to recognize that the base of all programming has more commonalities than differences, and it’s up to the organization and the people running it to apply frameworks, such as the WHO Healthy Workplace Framework and Model, that structure programming to achieve desired outcomes.

In my opinion, workplace wellness will continue to lean on technology to improve program outcomes and the lives of employees.  Given the global nature of our world, it’s easier for a company to promote flexible policies to their employees, to offer online learning courses to further knowledge around health and wellness, as well as personal development, and to manage and track employees’ attitudes and behaviors through engagement surveys, health software platforms and much more.  As a tech worker in San Francisco, I feel fortunate to be at the cutting edge of these changes, and I look forward to applying what I’ve seen work in my future career.

References

Burton, J. (2010). WHO healthy workplace framework and model: Background and supporting literature and practices. Retrieved from http://www.who.int/occupational_health/healthy_workplace_framework.pdf

 

Deloitte University Press. (2016). Global human capital trends 2016. Retrieved from https://www2.deloitte.com/content/dam/Deloitte/global/Documents/HumanCapital/gx-dup-global-human-capital-trends-2016.pdf

 

Global Wellness Institute. (2016). The furture of wellness at work. Retrieved from http://www.globalwellnesssummit.com/images/stories/gwi/GWI_2016_Future_of_Wellness_at_Work.pdf

At Scovill Technologies, there will be both positives and negatives to using delivery systems outside the organization for wellness programs.  On the plus side, given the demographics of the employee population (for example, the majority of employees are not college educated and the plant (majority of employees) is located in a small, rural, Southern town), an outside system may be the best way for the company to offer a fully comprehensive plan for wellness.  Unless the plant has someone on staff who is fully trained and educated in all things wellness, including how to boost engagement, how to be compliant with wellness laws, and how to successfully plan for and implement wellness programming, they may be better off hiring a wellness vendor that can take care of these details for them.  According to Aldana (2018, September 27), “the most effective wellness programs are focused on helping employees adopt and maintain healthy behaviors” and include features such as personal health assessments, education, methods of tracking participation and activity, ways to boost engagement, tactics for administering incentives and rewards, a platform encouraging social support, the ability to provide tools and demonstrate how to be healthy, and overall, significantly boost a health promoting culture.  All of can be very challenging for a small business, particularly without a devoted wellness manager and staff, to achieve on their own.

Scovill Technologies is also a relatively small business, employing only 250 people, which can be both advantageous to using an outside vendor, as well as a bit of a drawback.  Aldana (2018, January 10) states that small business wellness programs are often just as or more successful compared to larger wellness programs because they are more nimble an open to change, morale is generally higher, and participation rates are also typically higher as well.  In a small business, leadership is more visible, absenteeism impacts the bottom line in a much more obvious way, and these days, more brokers will work with small businesses and wellness providers have affordable solutions as well (Aldana, 2018, January 10).

Despite the positives of using an external delivery system for wellness, it is important to note that if Scovill Technologies used a broker, for example, they run the risk of encountering a broker who does not do anything to offer wellness programming to their clients (a majority of 54% of brokers fall in this category) (Aldana, 2016, January 8).  It is important to assess the needs of the company, the desired goals a wellness program should achieve, and to find the best solution, whether it be through a broker or wellness vendor, to maximize program results.

There are numerous methods and tools that can be used to assess the use of outside wellness vendors in delivering programming to a company’s employees.  The most important thing to keep in mind is that an “effective employee wellness program should be a healthy living support tool that helps individuals adopt and maintain healthy behaviors and it should use the best behavior change science to accomplish four objectives: educate and create awareness, motivate, teach health promoting skills and tools, create healthy culture and encourage social support” (Aldana, 2018, September 27).  With this goal in mind, Aldana (2016, October 4) recommends vetting a vendor by how they focus on creating and changing health behaviors, obtaining excellent references, how they utilize incentives (benefits-based incentives are much better than gift cards or rewards, for example), how long they’ve been around and how successful they’ve been in that period of time, and how much scientific evidence they can shed on the effectiveness of their programming.  He also recommends utilizing a vendor that stays current with technology and adapts to how employees use technology, but one who also has real humans there to help along the way (Aldana, 2016, October 4).   A great vendor will support and encourage a culture change, offers a guarantee for the success of their programming and outcomes, and offers a tailored, customized approach to programming (Aldana, 2016, October 4).

While I’m tempted to recommend that Scovill Technologies go with a wellness provider and vendor like WellSteps, which would certainly offer an excellent, tailored solution at an appropriate price for a small business, it also makes sense to explore options via government programs, such as the Centers for Disease Control and Prevention program.  According to the U.S. Department of Health and Human Services (2013), the Affordable Care has increased funding to help employers develop workplace wellness activities, including tobacco-free initiatives and increased flexibility for physical activity.  The CDC has tools, resources and guidelines for building and enhancing programs at work, and in particular, the National Healthy Worksite Program is focusing on small to midsize businesses to help bolster programming (U.S. Department of Health and Human Services, 2013).   If I had to choose which direction to go, it really would come down to two main things: budget and background with health and wellness programming.  If Scovill Technologies had the budget for an outside wellness vendor, this might be the best route, especially since it would reduce the need for a staff to support the programming and initiatives; however, if budget is limited, which is very well may be, going with a government-based program would be a great choice, though there would need to be a point person to execute on the initiatives. 

The business type impacts my choices because different businesses may have different needs.  For example, health care workers tend to have dramatically higher healthcare costs compared to other employees, have higher levels of stress, and are often more obese and have more chronic conditions compared to other kinds of employees (Aldana, 2017, November 1).  This type of business and employee population has specific wellness programming opportunities and needs, just like people from Scovill Technologies.  Making assumptions from the data provided, it seems as though there are many people employed at the company who have not received higher education (college or beyond), either live in incredibly urban or rural areas, and work in shifts and hours that may not be “typical” compared to the average 9-5 job.  According to the Robert Wood Johnson Foundation (n.d.), this business group may be impacted by health disparities, such as race, ethnicity, and socioeconomic status, as well as social determinants of health, like quality schools, affordable and stable housing, access to good jobs and safe neighborhoods and much more.  By understanding the type of people and the factors that may directly or indirectly impact their health, we can get a better sense of the business as a whole, and what programming will be most effective for the business’ population.  Given that Scovill Technologies is a small manufacturing firm, it may be safe to assume that people are working long hours (being that they are non-union), could potentially be exposed to workplace hazards and safety issues, and may not have the background knowledge or support from their community to know and change health behaviors.  

References:

Aldana, S. (2016, January 8). How brokers are offering wellness programs in the workplace [Web log post]. Retrieved from https://www.wellsteps.com/blog/2016/01/08/wellness-programs-in-the-workplace/ 

Aldana, S. (2016, October 4). How to choose the best workplace health promotion programs [Web log post]. Retrieved from https://www.wellsteps.com/blog/2016/10/04/best-workplace-health-promotion-programs/ 

Aldana, S. (2017, November 1). 9 reasons hospital wellness programs are a smart business strategy [Web log post]. Retrieved from https://www.wellsteps.com/blog/2017/11/01/hospital-wellness-programs/

Aldana, S. (2018, January 10). Why small business wellness is the future [Web log post]. Retrieved from https://www.wellsteps.com/blog/2016/01/27/small-business-wellness/

Aldana, S. (2018, September 27). 10 things your workplace health and wellness software should do [Web log post]. Retrieved from https://www.wellsteps.com/blog/2017/06/02/health-wellness-software/

Robert Wood Johnson Foundation. (n.d.). RWJF honors culture of health prize winners. Retrieved from https://www.rwjf.org/ 

U.S. Department of Health & Human Services. (2013). Report to congress on workplace wellness. Retrieved from https://aspe.hhs.gov/basic-report/report-congress-workplace-wellness#select_federal