Health and Wellness Programs for Commercial Drivers (2007)

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45 Why Wellness Programs Often Do Not Work. In the experience of the research team, perhaps more than any other corporate safety initiatives, employee wellness programs, no matter how well-intentioned, are plagued with obstacles. While this experience is not necessarily scientific, there seem to be obvious reasons and not so obvious reasons why these programs fail more often than not, or work for a short time, but are gradually discarded in favor of other initiatives with quicker results. Employee wellness programs are initially put in place with very well-intentioned goals in mind. These may include a genuine concern for the health and well-being of employees, lowering escalating medical and workers’ com- pensation costs, improving recruitment and retention, increasing productivity, and improving employee morale— all potential benefits that have already been described throughout this report. With all of these gains, making the decision to implement a successful employee wellness program should be an easy one. However, the operative word here is “successful.” A sig- nificant number of American companies implemented well- ness programs in the past 2 decades, but a check on the progress after a few years generally shows that many are either no longer involved at all or have reduced their health and wellness program to some periodic communication from which very few employees benefit. Perhaps the overriding reason is that “wellness” is a very personal issue, and making improvements can require mak- ing extremely difficult lifestyle changes (i.e., physical exercise, nutrition, smoking cessation, etc.). Coupled with the fact that a person is being asked to change habits that took decades to develop is the fact that any lifestyle change is going to be grad- ual, will take a substantial length of time, and demands per- sonal commitment to be sustainable. Most organizations are looking for more immediate results. Conservatively, most industrial health professionals say the ROI for a good well- ness/disease management program is somewhere in the neighborhood of 3:1 or 4:1. However, it can take a while for the savings to show up, it is difficult to isolate the savings as direct results of wellness programs, and the savings are diffi- cult to track. Most companies do not have a long-term view and lack a committed coordinator or adequate resources to attend to such matters. Due to the personal nature of wellness, the program cannot be a “one size fits all” type of effort. One employee may like walking on a treadmill while another may like to walk outside. Still others may enjoy organized sports. While the measure- ments of improvement can be consistent, how a person gets there should contain a number of options. The measures have previously been covered but the following is a quick review: • Weight • BMI (fat vs. muscle) • Blood pressure • Fitness level • Blood glucose • Degree of cessation of tobacco use/smoking • Blood total and HDL cholesterol The Health Enhancement Research Organization (HERO) is an organization dedicated to making employee health man- agement a widely accepted strategy for controlling health care costs. According to HERO, most of the solutions being tried are economic, but they fail to address the root cause of high insurance premiums—health issues leading to costly treat- ment. To a large extent, higher health care costs stem from unhealthy living. HERO indicates that from 50 to 70% of all illnesses and medical problems are associated with a relative handful of lifestyle choices: obesity, smoking, inadequate exercise, poor nutrition, and inability to manage stress (Goetzel et al. 1998). Research shows that people who are prone to these problems generally have much higher health care costs than those who are not. In fact, the numbers are even higher for the professional driver population. Compa- nies often begin by providing healthier menu items in C H A P T E R 5 Failure of Employee Wellness Programs

company cafeterias and setting up exercise facilities in com- pany locations, but these are often not available to drivers who spend most of their time on the road. To better understand the difficulty of implementing a sus- tained employee wellness program, it may be useful to look at some of the obstacles and mixed messages that can under- mine the effort. Many of these have already been described in detail; they are included here in summary form. • Missing a clear statement of philosophy, purpose, and goals of wellness program. • Wellness is a “priority” when it needs to be a “value” just as safety is a value. Priorities change, while values are for- ever. Must integrate wellness into the safety value. • Championing the program often doesn’t start at the top. • Failure to involve front-line management in the program. • Lack of management support. (Management personnel are not healthy either.) • No effective and qualified professionals to guide program and measure results. • No specific people have been assigned to manage the well- ness program. • Champion or sparkplug program leader gets program going and then gets promoted or leaves the organization. No depth in management to carry on. • Ineffective communication. • Unrealistic budget. • Not convenient/not accessible, particularly for over-the- road drivers. • Failure to involve employee’s spouse/family. Drivers need support on home front to reinforce the message, change diet, reduce stress, etc. • Actions don’t support the message (e.g., serving donuts or pizza as a snack or meal during wellness training). • Work culture/environment is unsupportive—vending machines, smoking areas, etc. • Takes too long to see the results. • Medical insurance premiums go up anyway (probably not as much as they would have but any increase is considered a failure in the short term). In contrast, the best practices of some of the safest facilities can be applied to successfully implementing a wellness pro- gram. When companies study their best performing loca- tions, the following are some of the underlying principles of achieving that exceptional performance: • Adherence to company programs – Manager holds himself/herself to a high standard of pro- gram management quality – Corporate programs are used as a starting point for facility programs. (This is an important point for any safety program. It should be more of a template rather than a full program and should be easy to fit to the facil- ity design and culture.) – Strong documentation and recordkeeping – Structured, well-planned training • Constant, active drive to improve – Further enhancement of corporate programs for maxi- mum effectiveness at the facility – Management review and feedback on work performed – Monthly meetings, open discussions to develop improve- ment ideas • Strong employee empowerment – Accountability assigned to employees for specific man- agement duties – Employees feel responsible for each other – Employees take ownership of programs – Teamwork is prevalent and supported – Employees understand corporate programs • Excellent management planning – Liberal use of computer software to manage programs and track results. – Daily, monthly, and long-term planning – Use of face-to-face meetings – Planning by management and employees • Strong focus on at-risk behavior identification and correction – Regular inspections and observations – Action plans, action item assignment (For wellness, employees would have personal action plans but might also have a coach.) In general, wellness programs implemented in well- managed locations with strong leadership and empowered employees have a better chance of success. Programs them- selves should be guided by professionals, offer an abundance of employee options, and be easily adaptable. 46