WELLNESS PROGRAM STARTER KIT
This ―starter kit‖ is intended to assist those individuals within an organization who have
been assigned or have taken on the role of starting or enhancing a wellness program for
the organization. The purpose of a wellness program is to promote good physical and
mental health practices among your employees and their families. Helping your
employees to establish and maintain a healthy lifestyle is not only good for them but can
have significant benefits for your organization. It almost goes without saying that healthy
employees have lower health care costs than employees with one or more health risk
factors. Furthermore, a number of studies suggest that the indirect costs of unhealthy 1employees may be two to three times higher than the direct costs. Indirect costs refers to
such things as absenteeism, ―presenteeism‖ (where employees come to work but don’t
meet acceptable productivity standards), and disability claims.
It is estimated that 50 to 70 percent of health care costs are the result of personal lifestyle 2choices; that is, they are avoidable. Implementing a wellness program is an excellent way to have a measurable, positive impact on your organization and on the lives of many
of your coworkers and their families. We want to help you succeed in the exciting and 3vital role you’ll play in leading the wellness charge for your organization. This starter kit
will provide you with the blueprint to either start a new wellness program or improve an
existing one. Our Corporate Wellness Consultants are available to help you, if you so
desire—ask your CBH account manager for details.
The first response of most people charged with developing a wellness program is to
immediately start planning an array of fun and exciting activities. However, there are
some important steps that need to come first. We highly recommend that you read
through this manual before getting started.
Step One: Get the Support of Senior Management
In order for your program to have the best chance for success you need the explicit
support of your organization’s senior management. This is because you will need their
assistance in gaining access to the rest of the organization, their active backing of your
goals so that others see the wisdom of getting on board and helping, and their approval
for any funding that your program requires. (It should be noted that you can do a limited
wellness program with little or no additional funding, but you are likely to want some
How you go about getting senior management support is important. You may or may not
succeed if you just approach them and explain why you think a wellness program is a
good idea. But a little planning can stack the deck in your favor.
Management is concerned ultimately with the profitability of the enterprise (or for
nonprofit organizations, with accomplishing the mission while staying within budget).
Therefore, you have to show them credible evidence that (1) improving the health
practices of your employees pays off for the company in some way, and that (2) a
wellness program stands a good chance of improving those health practices. To
accomplish this you will need to do some homework.
Find out what human resource issues are of most concern to your organization’s
management. Is absenteeism high? Are retention rates low (high turnover)? Are accidents
on the rise, or is quality of work slipping? Are disability or workers’ compensation
claims a significant concern? Are health care costs rising rapidly (and where are they not)? Point these out to the manager(s) you decide to approach, and explain that wellness
programs have been shown to lead to a reduction in health care utilization costs,
increased productivity, reduced absenteeism, a reduction in workers’ compensation
claims, and better morale, loyalty, and retention (see footnotes 1 and 2). A review of 73
published studies of worksite health promotion programs found that on average they 4 A meta-achieved a return on investment (ROI) of $3.50 for every dollar invested.
analysis of 42 published studies found that wellness programs led to an average of 28%
reduction in absenteeism, 26% reduction in health care costs, and 30% reduction in
workers’ compensation and disability claims costs.
Describe some specific wellness activities as examples that might impact each of the
areas you decide are major concerns in your organization. (See appendixes 1 and 2 for
ideas.) Finally, explain how you would measure success (keep reading for help with this). In sum, the key to gaining the support of senior management is to show them how a
wellness program will increase the organization’s competitive advantage. You do this
with specific data and examples, but be careful not to over-promise or your plan will be
dismissed as wishful thinking.
Step Two: Form a Wellness Team Once you have the support of senior management, the next step is to create a wellness
team. A team offers many advantages over going it alone. You get representation from
and ambassadors to many areas of your organization, you spread the work around (and
there is plenty of it), you gain the synergism of the many and the diverse, and you have stability and continuity if one or several people leave.
How do you decide who should be on the team? One key is diversity, in many senses of the word, including that team members should come from all areas and levels of the organization. People with health risk factors, such as overweight people and smokers, should be represented. This might surprise you, but they can give you realistic feedback on the likelihood of success of various initiatives aimed at changing these issues. They also provide credibility—if the whole team were paragons of health and fitness, they
might be seen as preaching, or as ―health Nazis.‖
Also, consider the skill sets that will be needed. You need people who are good at organizing events, at motivating people, and who understand the political lay of the land and can get things done in your organization. You need people who can do research and write convincingly. You need people who are respected and liked by other employees. Another consideration is whether team members should be appointed, and if so, by whom, or if you should ask for volunteers. Often a combination of ―invited‖ members and volunteers works best. Go to senior managers and others whose opinions you respect, and ask them to suggest team members. They might also be willing to approach those persons for you and ask them if they would be willing to serve. About eight to twelve members is a good size. If you still have space after inviting members, you might open it up to volunteers. The upside of this is that they are likely to be motivated. The downside is you might get members who are not a good fit.
Finally, the team will need a leader. This should be someone who understands the organization’s strategic priorities, as well as the wellness team’s role and vision, and can integrate the two. He or she should have a healthy lifestyle and truly care about health, be a good communicator and motivator, and have the people skills to lead a diverse group. This person could be you, someone chosen by senior management, or someone that you ask to serve in that role.
Scheduling of team meetings needs to be flexible. You will meet more often in the beginning and when a new initiative is underway. You should meet at least quarterly, regardless.
Step Three: Do a Needs Assessment to Guide Your Efforts
According to the Wellness Councils of America, 73 percent of organizations that implement a wellness program do so without first doing any sort of needs assessment. They just start implementing activities that ―sound good.‖ The first problem with this approach is that you don’t know where the greatest needs are, where you are likely to get
the best returns for your efforts. Imagine contracting for an expensive tobacco cessation
program only to learn that you have a relatively small number of smokers, and these are
diehards with little desire to quit.
The second problem with not doing a needs assessment is that you don’t know what your
employees want and, therefore, whether they will embrace the activities that are selected.
How would you know, for example, whether enough people would use a fitness center to
justify the expense of installing one, unless you asked?
A third problem is that, without comparable before and after data to compare, you won’t
be able to show measurable results or ROI. After you implement your wellness program,
suppose you find that your absenteeism rate is 15 percent. How would you know whether
that was an improvement unless you had measured it before you implemented the
program, and measured in the same manner both times?
You must do some kind of needs assessment if you want a first rate program. You may
have already started this process when you were seeking support from senior
management, but you will want to be more comprehensive at this point, and now you
have a team to help you do it.
As the preceding discussion implies, there are two main categories of data that you need
to collect; data that show: (1) how the business can gain the most from a wellness
program, and (2) what the employees want from such a program. Your program has to
provide a benefit to the business or it will fail for lack of support from above; plus, it has
to provide activities that employees want and will embrace, or it will fail for lack of
support among those it is intended to help. The team will need to synthesize these two
different but not necessarily incompatible objectives into recommendations that
Following are some useful sources of data for your needs assessment. You need not use
all of these, and you are not limited to these. Tip: Where feasible, you may want to break
out data for each separate worksite and department, as long as the groupings are large
enough to preserve the anonymity of employees. This helps you tailor activities to each
group’s needs, and target promotions to underutilizing groups.
I. Data to determine business needs.
? Medical/healthcare claims. Contact your medical carrier for help. Identify your
organization’s most common and most costly diagnoses, procedures, and drugs, and
the highest utilizing demographic groups.
? Behavioral healthcare claims. Similar to above. Break out inpatient from outpatient
costs, and mental health from substance abuse costs.
? EAP utilization data. Look at the most common presenting problems, demographics
of utilization, most frequent reasons for management referrals, types of post-EAP
? Health Risk Assessments (HRAs) can efficiently give you a lot of useful data on the
health-related strengths and weaknesses of your employee population. HRAs have the
advantages of being standardized, reliable, inexpensive, and are repeated over time to
give longitudinal data. They can even be customized to fit your needs, and can give
you additional data for your wellness program on such things as:
o Demographics of your population, special characteristics, geographic barriers;
o Health care needs, risks, and chronic conditions;
o Employees’ interests, in terms of wellness activities (see section II below);
o Readiness to change; i.e., employees’ expressed interest, or lack thereof, in
changing certain behaviors, which helps you to target your efforts where they
will do the most good;
o Perceptions of the your organizational culture, and ideas for improving it (see
step seven below);
o Wellness program participation rates and participant satisfaction.
Talk to your medical carrier if you don’t have an HRA in place. There are free HRAs
available on the Internet but they won’t give you the ability to do sophisticated
computer data analyses that you will get through your medical carrier or another
? Short- and long-term disability and Workers’ Compensation claims. Look especially
at reasons or causes.
? Health screening data, usually gathered at a health fair. Includes such measures as
cholesterol, blood pressure, body mass index, and hearing.
? Turnover/retention rates. Exit interview data is especially helpful at uncovering
reasons for turnover, and clues for improving retention.
? Absenteeism rates and reasons.
? Accident/safety records, facility/environment assessment for sources of risk and stress.
II. Data to determine what employees want.
? Consider conducting focus groups with employees from different departments,
different locations, and different levels of the hierarchy.
? Do an online survey questionnaire (see appendix 3).
? Have wellness team members each interview a certain number of employees. ? Look at patterns of utilization of previous wellness offerings. What was popular and
what was not? For example, if you have offered fitness club discounts, how was
utilization? Were the discounts too small to be meaningful, or club locations
The next step is to analyze the data you have collected, figure out what it can tell you,
and make recommendations based on the results. If this is not your strength, don’t
hesitate to ask for help from someone with stronger data analysis skills.
The analysis should ask the following kinds of questions about the data.
? What appear to be the greatest health and wellness related problems and challenges of
the employee population, in terms of direct and indirect costs to the organization?
? What are the main reasons employees leave this organization, and what do they say
would keep them here?
? How significant are the rates of accidents and disability claims? Is either a major
problem? What are the main causes of each?
? Is absenteeism too high? What are the main reasons for it?
? What are some of the main sources of stress in the work place? Is it a problem? ? Considering all of the above, which areas can we most readily impact, and how? That
is, where are the greatest opportunities for a wellness program to make a difference? ? What would each of the preceding opportunities for intervention cost? Which would
likely be most cost-effective in terms of ROI?
? Which do the greatest number of employees say they want? Which do they sound
most passionate about?
Now the task is to put it all together and make recommendations for program goals,
objectives, and activities. These recommendations will need to take into account where
the needs are greatest, where a wellness program can actually change health outcomes,
which activities offer the greatest return for the time, money, and other resources that are
needed to make them a success, and which activities are likely to be embraced by
employees. Formulating recommendations is a complex balancing act that requires
integrating many sources of information. It is as much an art as a science.
The final task for step three is to write all of this up in a formal report. This is important.
Tap someone from the team with good writing skills. Have it critiqued, revised, then
proofread. Senior management will like that.
An important caution: You have gathered some potentially sensitive data, both at the
levels of the organization and the individual employee, and you must take precautions to
keep it confidential. Share it on a need-to-know basis, or better yet, let your manager
decide who gets to see it, and keep it in a secure place.
Step Four: Create an Operating Plan (in writing) At this point, it is time to create an operating plan and put it in writing, for a number of
reasons. First, senior management will probably ask for one. Second, it provides vision
and direction to the wellness team and other interested parties—it shows what needs to
happen and when, and makes sure all are playing from the same sheet of music, so to
speak. Third, it holds people accountable by specifying who is responsible for what.
Finally, it provides continuity through changes in staff—new team members can read the
plan and get up to speed quickly.
A wellness program operating plan should have at least the following components:
Explain the reasons for deciding to implement a wellness program. The introduction
should answer: Why is such a program good for the organization? How will it also help
employees and their families. You can cite both national data and data you have gathered
about your organization in step three.
Goals are broad and high-level, in comparison with objectives, which are specific. Goals
indicate what you have decided to target with your wellness program, based on your
needs assessment in step three. Goals tell you how you will know when you have
succeeded. They help show the way toward specific objectives and activities. For
example, one of your goals might be to reduce (or prevent increases in) health care costs
for lifestyle-related medical conditions.
Objectives should each be tied to one of your goals, and should be SMART: specific,
measurable, achievable, realistic, and time-specific. Each goal will likely have numerous
objectives tied to it. An example of an objective for the above goal might be: Cafeteria
will offer at least three vegetables, a salad, two lean meat entrees, and a low fat dessert
every weekday, beginning no later than March 4, 2007.
Implementation strategy, timelines, and persons responsible.
This section and step five, Choosing Appropriate Interventions, are likely to be
accomplished simultaneously. Based on your objectives you need to decide on specific
activities, how to implement them, timelines, and the person or persons responsible for
Methods of communication and promotion.
This section of your operating plan details how you will communicate and promote your
wellness program activities to your employees and their families. Take a look at your
work force: How do they prefer to receive communication from the organization? What
media and approaches work best for them? Do they like games, competitions, prizes? Are
they widely dispersed or all located in one or a few locations? What kind of a budget and
in-house capabilities do you have for communications?
The answers to these kinds of questions will help you decide how to ―sell‖ your program.
Media can include e-mail, posters, flyers, newsletters, and your intranet. Using multiple
media and frequent repetition works the best.
Promotional strategies can include themed ad campaigns (spring fling, springing into
wellness, the Olympics of health, etc.), competitions, prizes, and health fairs. You can tie
your activities to national health observances and theme programs; a list of these is
available by contacting the National Health Information Center of the U.S. Department of
Health and Human Services at 800-336-4797 or by going to:
As noted in step one, you can start a limited wellness program with little or no new funding; however, you can do a lot more if you are given a budget. And it is important to
remind those who must approve the budget that it is an investment, not just an expense.
Remember, average ROI is $3.50 for every dollar spent. Of course, how you spend your
budget is crucial to your ROI. Be sure to put the most money where you are likely to get
the best returns. Once approved, include your itemized budget in this section of your
This section summarizes how you will evaluate the results of your wellness program after
a specific time period, usually a year or more. It explains how you will measure outcomes
to determine where the program was a success and where it was not, what you need to
change and what you should continue doing.
An evaluation plan flows naturally from your needs assessment, goals, and objectives.
The needs assessment provides much of the before data, which you compare with after
data at the point of evaluation. We will go into detail about the evaluation process in step
eight, Evaluate Your Results.
Step Five: Choose Appropriate Activities
There is a logical progression from needs-assessment data, to goals, to objectives, to
activities. If the preceding steps are done well, deciding on activities will be the fun and
easy part. Just be sure your choice of activities is based on the data you have collected, in
order to get the best results from your program.
Following is a useful system of classification of wellness program activities. Appendix 1
lists ideas for specific activities to get you started on the creative process:
1. Education, awareness, and support. Topics can span a broad spectrum; for example,
stress management, how to minimize your risk for certain conditions such as Lyme
disease or skin cancer, coping with change, conflict resolution skills, reminders about
getting regular physical exams, balancing work and personal life, parenting skills,
keys to a healthy marriage, healthy exercise, heart-smart nutrition, and financial
planning. The information may be delivered in various forms, including lunch-and-
learn or brown-bag seminars, posters in the workplace, tip sheets sent as home-
mailers, and intranet web pages.
2. Health screenings. Usually performed at health fairs, health screenings are aimed at
detecting health conditions or risks that are best addressed early. These include breast,
prostate and skin cancer, diabetes, cholesterol, body-fat testing, posture screening or
spinal analysis, depression, and blood pressure. Flu shots and child immunizations
can be included in this category, though they go beyond screening.
3. Safety and prevention. This category includes back-injury-prevention training,
ergonomic education, all workplace safety policies and procedures, and information
about avoiding identity theft and other types of crime.
4. Lifestyle change or behavior change. Lifestyle or behavior change programs are
among the most ambitious wellness activities. They seek to help employees who want