changes that work the healthy worksite initiative hwi outcomes conference kathy reims, md september...

Changes that Work

The Healthy Worksite Initiative

HWI Outcomes ConferenceKathy Reims, MDSeptember 23, 2009

Aim

Develop and refine interventions that influence health behaviors and lifestyle choices, resulting in improved employee health status and eventually positively impacting the rising health care cost trend

Legislated Measures

Reduction in % of population that is overweight or obese (HRA and biometrics)

Reduction in risk factors related diabetes (biometrics)

Reduction in high cholesterol (biometrics) Reduction in high blood pressure (biometrics) Reduction in risk factors related to

absenteeism HRA and WLQ) Reduction in tobacco consumption (HRA and

claims) Increase in appropriate use of preventive

health services (claims)

Measures

Identify agency policy, environment and “culture” changes that contribute to improved employee health status

“What can the agency do?”

Increase percentage of employees who are in the low risk category (0-2 risks from HRA)

“Is the population getting healthier?”

Program Components

Onsite biometric screening and health risk assessment every six months

Individual, environment, and policy interventions

Focus on changes that the agency can make to improve employee health

Guiding Change

IHI Breakthrough Series Expert Panel Change Package Results-oriented approach

HWI Change Package

Participation

38% of the eligible population screened at least once. (Range 23 – 76%)

Identified Risks: 3898 screenings

Demographics

Obesity Trends* Among U.S. AdultsBRFSS, 2008

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

Context to Consider Weight Trends

National statistics show that weight gain during adulthood has increased by > 50% in the past 30 years.

Weight gain in young adults 18 – 30 averages about 1 kg/year.

Overweight or Obese

31 % lost 6 or more pounds in one year!

Diabetes Risk Factors (Physical inactivity, Overweight, Hypertension, Lipid, FBG>100)

3 2 1 005

101520253035

Modifiable Diabetes Risks

June-08June-09

Number of Risk Factors

Perc

en

tag

e

Cholesterol(Total, HDL, LDL, Triglycerides)

3 2 1 00

10

20

30

40

Lipid Risk Factors

June-08June-09

Risk Factors

Perc

en

tag

e

High Blood Pressure

Systolic >120 and/or Diastolic > 80 decreased from 68% to 63%

Physical Activity

Those who were inactive decreased from 54% to 46%

Overall Risks(BP > 120/80, lipid, inactive, BMI>25, FBG > 100)

9% Decrease

Employees took Action

Affirmation of the Effort

69% agreed that “HWI provided new information about myself.”

Take Home Points

High level of risk identified Early data encouraging that risks

can be diminished Employees took action to improve

their health and felt supported by agencies