Getting started

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Getting started on a workplace weight
management programme
Dr Koh Yang Huang Manager, Workplace Health
Promotion
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National Health Survey, Singapore
Source MOH Among Singapore residents aged 18-69
years
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Leading Causes of Death
Source Ministry of Health Annual Report 2002
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A Review and Analysis of the Clinical and
Cost-effectiveness Studies of Comprehensive
Health Promotion and Disease Management Programs
at Worksite 1998 -2000 Update by Kenneth
Pelletier

• American Journal of Health Promotion 2001
  16(2)107-116

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Study Purpose of study Intervention design Findings
Goetzel et al Compare total and lifestyle related medical expenses in a WHP programme participants vs non-participants Voluntary participation in a worksite health promotion programme Adjusting for age and gender, participants had lower (29-36) medical costs compared to non-participants
Burton et al Determine direct and indirect costs of obesity/overweight Tracking healthcare costs (sick days medical bills) of employees with high vs healthy BMI over 3 years High BMI employees averaged US8,779 vs US5,425 for healthy BMI employees
Fries and McShane Compare targeted programmes against each other and comparison groups receiving standard Healthtrac programme Voluntary enrollment in WHP and/or targeted programmes Targeted programme score better than standard programmes HRA score 11 vs 9 doctor visits fell by 1.6 MC fell by 1.8days/yr HR costs reduced by US608 vs US113
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Workplace Health Promotion is a
process of enabling people to increase control
over and to improve their health within a
workplace setting. ? Ottawa Charter World Health
Organisation 1986

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• Health is a
• state of complete physical, mental and social
  wellbeing and not merely the absence of disease
  or infirmity.
• ? Declaration of Alma Ata, 1978

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• Getting Started

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Secure support
1. Set up committee
2. Assess needs
3. Write goals objectives
4. Select interventions
5. Market and Implement
6. Evaluate
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1. Set up a good committee

• Influential leadership
• Clear chain of command
• Representative
• 5-7 members
• Trained staff
• Recognition
• Opportunity for growth
• Integrated

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2. Assess needs
Identify what is important to staff when
designing workplace health programme Understand
different spectrum of needs, expectations,
etc Set the right priorities
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What Data to Collect?

• Employee
• Demographics
• Health status
• Health risk factors
• Fitness status
• Health practices
• Staff satisfaction
• Interests/preferences
• Mental health status
• Readiness to change
• Significant others

• Organisational
• Medical care costs
• Absenteeism
• Staff turnover
• Physical environment
• Cooking facilities
• Water coolers
• Sports and recreation facilities

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How to Collect Data?

• Observation
• Verbal feedback
• Existing data
• Survey
• Health screening
• Focus group discussion

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Determine priorities

• Criteria
• How big is the problem
• Is it serious
• Are there solutions
• Are solutions acceptable
• Do weve the resources

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3. Write goals and objectives

• Specific
• Measurable
• Action-oriented
• Realistic
• Time-bound

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Example By Dec 05
Short to medium term objectives

• 40 staff participate in gt 1 Wt Mgt Activity
• 50 of staff with BMIgt25 attend Wt Mgt Class
• 15 of Wt Mgt Class attendees achieve wt loss
  goals
• Revise canteen menu
• Replace palm oil with canola oil
• Use HPBs list of approved caterers with
  immediate effect

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Example By Dec 2007
Long term objectives

• Proportion of staff with moderate to high risk
  BMI falls from 40 (05) to 35
• Proportion of staff with HPT falls from 22 (05)
  to 19
• Average healthcare bills falls from
  89/staff/year (05) to 82/staff/year

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4. Select interventions

• Include Mass and Targeted
• Range of topics - healthy eating, diet
  diseases, psychosocial cues to eating, physical
  activity, stress mgt, high blood pressure, dining
  out, reading food labels
• Balanced across 3 components organisational
  policies, supportive environment, lifestyle
  personal health skills

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Exercise programmes for small companies

• Offer gym membership
• Protected time to exercise
• Longer lunch breaks
• Aerobics Mile Programme
• Stair climbing

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S.I.M.P.L.E. Checklist

• Specific to needs
• Innovative
• Manageable
• People-oriented
• Lasting
• Evidence-based

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5. Market programme
telling them
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Choose popular channels

• Letters and memos
• Banners
• Staff Notice Board
• Staff meetings
• E-mail
• Pop-up e-posters
• Signages near
• queues in canteen

• Payslips
• Inhouse newsletters
• T-shirts, balloons, message buttons
• Videos
• Brochures
• Feedback boxes
• Personal persuasion

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Branding
e stablish
e ngage
BPs Best Practices
5e Ways
e njoy
e asy
e xcite
Investing in healthy employees
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Enjoyable
Enjoy
Diverse Activities (variety)
Encourage Team Work (team spirit)
Friend-get-friend effect
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Chinese New Year Countdown
Exciting

• New year resolutions
• Customised fortune cookies with health messages
• Healthy wok demonstration low fat recipes
• Exercise activities tai chi, martial arts

Publicise Creatively
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Easy to Participate
Minimal disruption to work

• Step Out Challenge BPS
• Staff carries a pedometer and it tracks the
  number of steps walked.
• No intervention required
• More than 50 of staff participated
• Interactive website maps out distance travelled

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Time your activities

• Avoid peak periods
• Ride on campaigns or topical concerns
• Integrate with on-going activities

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Easy to Say YES
Offer plenty of support

• Early time-off for WHP activities
• Provided transport where necessary
• Provided meals where possible

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6. Evaluate programme

• Know the object(s) of your evaluation
• Evaluate against your goals objectives
• Ongoing

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PLAN
IMPLEMENT

SUSTAIN
EVALUATE
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• It must be sufficiently long
• 3-6 mths to reduce personal risks
• 3-5 years to demonstrate cost-effectiveness

• Eyees need to perceive that mgt has positive
  attitudes toward health

Kenneth Pelletier Review analysis of clinical
cost-effectiveness studies, Am J of Health
Promotion 2001 16(2)107-116
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• Tapping on HPB

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WHP Grant up to 10,000

• To incentivise companies
• 5,000 to 10,000 matching grant

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HealthPROTM Eat for Health

• Encourage healthy eating habits
• Highlights
• Health corners
• Healthy catering policy
• Fruit and vegetables bazaar
• Outdoor physical activity
• Experiential learning

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E-Bytes

• E-mailed worksite nutrition intervention to
  promote healthier dietary practices
• Features
• Online dietary survey
• Immediate personal feedback
• Company report
• Bite-sized dietary tips twice weekly X4 wks

Hpb_nutrition_dept_at_hpb.gov.sg
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Healthy Catering _at_ Work

• Encourage workplaces to provide healthier food
  options in
• Cafeteria
• Corporate functions/receptions
• Conduct culinary skills workshop for food vendors
• Conduct seminars for canteen reps
• HPBs list of approved caterers
  http//www.hpb.gov.sg/hpb/default.asp?pg_id1390
  

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Infrastructure Support

• Training
• Resources
• Directory of service providers
• Best practices
• Health Information Centre

http//www.hpb.gov.sg/healthatwork