Worksite Health and Wellness

1. Worksite Health and Wellness A Case Study on a Program for Commercial Motor Vehicle Operations Erin Mabry Center for Truck and Bus Safety Virginia Tech Transportation Institute

2. Health and Wellness: Why is it Important? 2 Increased energy Improved quality of life Alertness and job performance Longevity on the job Increased life expectancy

3. Benefits of Improving Employee Health • Crash prevention • Job performance • Lower absentee rates • Reduced stress • Injury prevention • Weight control • Reduced fatigue

4. Components of wellness

5. Work-Site Wellness Programs • Prevent major health risk factors • Lifestyle-related diseases • Engaging and supporting employees • Convenient • Motivation and support • Often includes family • Benefits employee and employer • Becoming increasingly popular

6. Health and Wellness (H&W) Program • In 2008 Schneider National Inc. (SNI) launched a company-wide, voluntary H&W Program • Atlas Ergonomics • United Healthcare (UHC) and OptumHealth • Targets • Health disparities • Safety-sensitive positions

7. CMV truck driver lifestyle • Sedentary • 66% self-report no physical exercise (Moreno 2006) • Poor nutrition and eating habits • 75% do not meet the USDA minimum recommendations for daily vegetable consumption (Whitfield 2007) • Sleep deprivation • 3.8 hr/night on workdays (Perez-Chada 2005) • Long and irregular work hours • 11 hours driving and 14 hours on-duty (FMCSA 2005) • Rotating day/night shifts • High Stress

8. CMV drivers and obesity • Prevalence of obesity • CMV drivers: <70% (Smith 2011) • U.S. adults: ~33% (Flegal 2010) • Other chronic diseases including • Type II Diabetes (TIID) • Dyslipidemia • Obstructive sleep apnea (OSA) • Cancers • CVD • Reduced life expectancy • 12-19 years

9. Cardiovascular disease: a health and safety concern • Leading cause of medical illness and sudden death in CMV drivers(FMCSA Guidelines 2002) • May increase crash risk (FMCSA Executive Summary 2006) • May medically disqualify • Relevant to professions with safety-sensitive positions, warranting early identification and treatment • Construction • Mining • Aviation

10. SNI Health and Wellness (H&W) Program Overview • H&W Program targets: • Wellness coaching to >17,000 insured employees • Health behaviors and chronic disease prevention\management • Ergonomic and injury prevention services • On-site physical and occupational therapy and health screens • Nutrition and exercise education and counseling

11. Scope of Problem Drivers may have a 12-19 year reduced life expectancy (Salzman 2007) Driver Quote: “Too many truckers are out of shape and overweight, anything that would help them be in better shape would make the roadways safer.”

12. Project Goals Examine and detail the H&W Program Participants’ opinions, perceptions, and satisfaction with the H&W Program Recommendations for CMV fleets wishing to implement a H&W program

13. Methods • Phone interviews with key personnel • Recruitment methods, tests and assessments, wellness education, health coaching, health achievements, motivational strategies, and long-term follow-up • Evaluate participant opinions, perceptions, and satisfaction with the H&W Program • 94 drivers and 27 staff completed • Recommendations

14. Results: H&W Program Overview • Recruitment • Voluntary, incentive program • Well marketed • Address driver fears • Benefit champions • Health Assessment and Biometric Screen • Safety and health behaviors, stress, work satisfaction • BMI, BP, glucose and lipid panel • Multiple modes of collection • Health rating for medical referral • Review and Coaching • Individualized review of results • Feedback, suggestions, goal-setting • Face-to-face and phone coaching • Transtheoretical Model of Change • Educational materials • Follow-up • Program Components and Activities • Additional health programs • Smoking cessation, weight loss, etc. • Group competitions

15. Results: Driver Opinions • 67% chose to participate • 61% reported improved health • 95% would recommend the H&W Program • Program Likes • Dedication to driver health • Convenient • Financial incentive • Program Likes Con’t • Health coaches • Proactivity and health awareness • Resources, tools, and support • Program Dislikes • 59% reported none • Inadequate number of participating sites • Concerns over privacy • Inconvenient for 3rd shift or irregular schedules

16. Driver Suggestions for Improvement • Greater availability of health coaches • Improve anonymity • More health information (holistic) • More/fewer health tests • Exercise opportunities • Health club memberships • Additional participating sites • Additional incentives

17. Results: Staff Opinions • 68% of staff satisfied with the Program • Program Likes • HRA incentive • Health assessment/testing (multiple modes) • Coach/driver rapport • Individualized assessments and coaching • On-site therapists • Health-specific programs • Wellness calls • Program Dislikes • Driver participation inadequate • Driver motivation • Lack of wellness program participation

18. Staff Suggestions for Improvement • Program marketing • Focused info at orientation and training • Health podcasts, videos • Educate and train carrier staff • Ensure privacy of health information • Expand participating sites • Encourage driver initiative and self-motivation • Flexibility with driver schedules • Providing and encouraging opportunities for exercise • Enhance follow-up • Interim rewards

19. Lessons Learned Convenient access to on-site healthcare Distrust and confidentiality concerns Health assessment and biometric screening Individualized coaching Drivers want coach advocates Coaches work with drivers to anticipate barriers and setbacks Provide education and training materials that cater to drivers and the challenges they face

20. Lessons Learned Con’t • Driver-to-driver advice, coaching and support • Participation by a spouse/family member • Tobacco cessation and weight loss • Infrastructure changes • facilities that enable and promote exercise and healthy eating • Effective communication • Management support

21. Implications for the Construction Sector • Low obesity rates (~20%) [CDC] • Health concerns [OSHA] • Musculoskeletal disorders/pain • Stress • Smoking • Poor nutrition • Fatigue • Barriers to health • Long work days • Travel between worksites • Limited facilities for food storage/prep • High-hazard occupation

22. Implications for the Construction Sector con’t • Construction workers recognize that better health improves safety, productivity, and reduces absenteeism • Construction workers want to improve their fitness and dietary habits [Uher 1998] • Off-site exercise opportunities • Access to healthy food at work

23. Recommendations • Market program • Educational component • Large network • Clinical and physical testing • Multiple modes for data collection • Privacy of health information • Trust and rapport • Exercise coaching and monitoring • Regular communication, individualized, follow-up • Variety of health programs • Educational media and social support • Health podcasts and videos • Discussion forums • Success stories • Program flexibility • Participation incentives