The committee must be composed of a cross-section of staff representing various occupations, levels, and subgroups with the organization.

A common mistake is filling the committee with the most health/fitness-conscious individuals  in the business. Don’t rely solely on volunteers to fill a committee. Be certain that your committee members have enough power in the business to run an effective health promotion program.

The wellness committee is made up of employees from the workplace. It oversees the health promotion program and helps carry it out.

The committee should meet about once a month to review the previous month’s activities and plan future ones. When the program is just starting, the committee may meet each week until things get going.

Committee members don’t carry out medical procedures, counsel clients, or handle confidential health information. Wellness specialists perform these tasks.

In general, the committee’s duties fall into three areas –  planning, promoting, and assisting to run programs.

Creating the programs can include –

• Finding space for activities

• Developing and organizing worksite-wide events such as contests

• Reviewing reports prepared by the program staff and making recommendations

Marketing the program can include –

• Recruiting employees to take part in screening and health improvement programs

• Encouraging workers to participate in follow-up counseling

• Organizing promotional strategies using newsletters, signs, bulletin boards, computers, and other media available within the workplace

Helping to run the program can include –

• Setting up equipment for various activities

• Assisting to conduct worksite-wide activities

• Monitoring all activities and reviewing  the performance of the professional staff

• Acting as wellness mentors to fellow staff members

The size of the wellness committee will be dependent on the size of the organization. Select members by asking day management to nominate or appoint staff members.

Make an announcement through flyers, memos, and meetings to recruit potential members. Explain the purpose of the committee, duties and responsibilities, and the time commitment.

Recognize your wellness committee volunteers. Allow them to take part in programs at a reduced cost. Hold appreciation breakfasts/lunches/dinners.

Print names of committee members on company communications about the wellness program.

Buy special T-shirts, caps, and buttons for them. Write letters to supervisors saying that you appreciate the member’s service. Develop awards certificates for members.

The following can be used as a guide for committee size –    

• Less than 300 employees   2 to 4

• 300 to 1,000 employees   4 to 6

• 1,000 workers or more   6 to 12

It includes coworker support from family, friends, and coworkers. This support can help one adopt healthy life choices. Tools are available to audit a business.

The long-term success of any health promotion program is dependent on the corporate culture.

Some healthy culture signs in a corporation are –

• Employees communicate openly

• Leaders support diversity and opinion

• Workers have fun

• Policies support wellness

• Workers are encouraged to grow

• Employees work together as a team

• Employees’ skills and talents are matched to their jobs.

• Flexible work schedules are available

• Employers consider workforce as their most asset

Individuals  have a sense of community, a shared vision, and a positive outlook. Policies promote and support wellness efforts within the workplace.

• Effective programs identify ways that company policies and organizational traditions encourage wellness.

• Effective programs work at the group and organizational level to build support for healthful lifestyle choices.

• Effective programs set clear target objectives and objectives for the health improvement of the worksite.

The information you need to get from a recent survey depends on the scope of your program. A sample survey can be acquired in the HOPE Publications Web site.

When you plan to adapt this sample survey or create your own survey, keep the following hints in mind –

• Ask primarily closed-choice questions, specifically when you’ll be sending the survey to a big number of staff members. Closed-choice questions provide specific choices and are easy to tabulate. You might want to use a computer for data entry and analysis.

• Invite comments, suggestions and recommendations, or ask open-ended questions after the survey. Open-ended items are more challenging to summarize.

• Include a brief explanatory cover letter with the survey with the signature of the corporation president. Make certain to include a statement about confidentiality and anonymity.

• Ask a group of representative staff to review the survey before it’s distributed. Find out when the questions will be understood by staff and will not be objected to.

• Include demographic information at the beginning or end of the survey. Consider various ways that you might analyze the responses by demographic characteristics (gender, age, shift, site, department, etc.).

When considering who should get the survey, a simple rule is when you’ve under 500 personnel, everybody should receive one. the public relations benefit of everybody receiving a recent survey could be significant.

Over 500 staff members, a sample of the work population will suffice. A sample saves on costs and time. You could want to consider consulting with a statistician to determine an appropriate sample size for your worksite.

Needs surveys are confidential and anonymous; they do not request information that may identify a person.

Getting support from management is crucial to the success of the program.

One way to do this is to survey managers (see forms) and conduct interviews with decision-makers in the organization. You can use the surveys here or make up your own.

When you decide to do your own, keep the survey short. It should not take more than ten minutes to complete.

The interview process can also serve as a means of educating management. Give concise fact sheets on the advantages of health promotion programs for management.

When surveys and interviews are completed, tally the surveys and write brief summaries of the interviews. Provide these reports to management.

Once completed present a brief executive summary to management. Highlight a few intriguing findings that can be used immediately to make decisions about the program.

Utilize charts and graphs to make your points. Prepare a detailed report for wellness committee members itemizing each response. Give a short article about the survey in the corporation newsletter.

The higher the response the more accurate and reliable the results. A minimum response of 40% to 50% is acceptable.

Robust health promotion programs emphasize follow-up and offers support for the staff member as long as he/she is employed. Studies have shown this approach to be highly successful. Key components are planning, implementation, and examination.   

Planning comprehensive wellness programs involve performing a needs and interest assessment, appointing a wellness committee, selecting  wellness providers, establishing goals/objectives for the wellness program, marketing/promoting the program, and establishing procedures to ensure confidentiality.   

Implementation of comprehensive health promotion programs consist of five major tasks –    

1   Biometric screening and referral

2   Follow-up and counseling personnel

3   Follow-up with physicians

4   Health betterment programs

5   Organizing worksite-wide activities.

Examination involves monitoring health promotion programs to find out when it is working and to help you refine it. Measuring success shows what you’ve achieved, helps justify costs, and provides information for management to support continued programming.   

Comprehensive wellness programs involve all staff members, deal with all major health risks, offers choices, and target both the staff members and the worksite environment; provide periodic examination of its results.     

Extensive wellness programs emphasize follow-up and offers support for the employee since he/she is employed. Studies have shown this approach to be highly successful. Key components are planning, implementation, and investigation

Planning robust health promotion programs involve performing a needs and interest assessment, appointing a wellness committee, picking  wellness providers, establishing goals/objectives for the health promotion program, marketing/promoting the program, and establishing procedures to ensure confidentiality

Implementation of extensive health promotion programs consist of five major tasks –

• Medical testing and health risk (assessment|appraisal}

• Follow-up and counseling employees

• Follow-up with physicians

• Health betterment and illness avoidance programs

• Organizing worksite-wide wellness program activities.

Evaluation involves monitoring wellness programs to find out if it is working and to help you refine it.

Measuring success shows what you’ve achieved, helps justify costs, and provides information for management to support continued programming.

Health promotion programs for personnel became more widespread during the following decade, and credible evidence for their economic viability started to be published.     

There have now been over 100 published studies on this topic and a number of systematic reviews.

Health risks increase costs.  Medical and health insurance costs escalate with both age and number of risks present.8,10   the number of risks is also strongly related to sick time absenteeism, Employee’s Compensation costs, short-term disability, and reduced productivity (”presenteeism”).

Early staff member health promotion programs were relatively basic and normally produced a ROI of less than one dollar for every dollar spent operating the program (ROI = <1 - 1).8

Such programs could  be characterized as “fun-oriented”.  Participation is entirely voluntary, and there is no particular focus on the reduction of specifically identified high risks.  

Interventions and activities are not personalized, and there is no emphasis on the management of health care costs.  These programs are typically site-based only, lack options to address all of the major behaviorally-related health risks, and lack multimodal presentation.  

Minimal or no incentives are provided to employees for participation, and services to spouses and family members aren’t available.  Most such programs lack meaningful analysis.  

More conventional programs are “activity-oriented” and have shown an ROI of between 1 – 2.5 and 1 – 3.5.8 These programs might have a greater emphasis on health and risk reduction, although the efforts are relatively broad and not customized.  

They might have some generalized emphasis on health cost management, although not necessarily aimed at specific high risks.  Most are site-based and voluntary, with spouses included only rarely.  

Modest incentives might  be utilized to encourage participation.  Formal evaluation might  be weak.

The newest and most economically viable programs are “results-oriented” and exemplify the health and productivity management model.  These programs consistently produce return rates of 1 – 4 or greater within a 12-24 month period.8  

Such programs are strongly focused on the reduction of namely identified high risks and the management of healthcare costs.  They’re normally voluntary, but use strong financial and other incentives to promote participation.  

They are multi-component in nature (address all major risks), and have both on-site and virtual modalities of operation.  The interventions are highly targeted and individualized, and offered to spouses in addition to workforce.

For organizations, the cost of providing medical insurance for their workforce is of great importance.  Those costs have been increasing at annual rates between 6 percent and 14 percent.

Chapman’s 2007 systematic review7 reported an typical reduction in health care costs of 26.5% thus of staff member health promotion programs.  His review covered 60 of the most scientifically precise studies, with an typical of 3.77 years of study.

Absenteeism because of illness is another cost driver.  Chapman’s review7 reports an average reduction in sick time of 25.3 percent.   Cost for Employee’s Compensation was lowered by 40.7 percent, and disability costs by 24.2 percent.

There is also an emerging literature on the costs of presenteeism (reduced productivity).11,13  In one study, every risk decreased through a health promotion program yielded a 9 percent reduction in presenteeism (and a 2 percent reduction in absenteeism).11

Some corporations have achieved a zero% increase in health care costs across at least brief periods of time.10  Doing so requires 90-95% participation of the employee population in focused health promotion programs, with 75%-85% of the workers falling into the low risk category.10     

Although comprehensive efforts to lower the risk status of those in moderate or high risk categories must be made, the needs of currently healthful personnel must be addressed as well to avoid increases in risk-status.   

Given the size of the federal workforce, significant cost savings in the government’s contribution to medical insurance premiums for personnel can be achieved if a majority of that population were participating in active wellness programs.     

Similarly, improvements in absenteeism, staff member’s compensation, disability, presenteeism, and turnover so of robust employee wellness programs would yield substantial fiscal benefits for the government.   

References   

1   Aldana, Steven G.  (2001)   Financial Impact of Wellness Programs –   A Robust Review of the Literature.   Am J Wellness 15(5) – 296-320.

2   Chapman, Larry.  (1998)   the Role of Incentives in Wellness.  The Art of Health Promotion  2(3) – 1-8.

3   Chapman, Larry.   (2003)   Biometric Screening in Health Promotion –   is it Really as Important as We Think?  the Art of Health Promotion  7(2) – 1-12.

4   Chapman, Larry.  (2005)   Meta-Examination of Company Health Promotion Economic Return Studies –  2005 Update.  The Art of Wellness, July/August, 1-15.

5   Chapman, Larry.   (2006)   Worker Participation in Company Health Promotion and Health Promotion Programs –   How Important are Incentives, and Which Ones work Best?   North Carolina Medical Journal   67(6) –   431-432.

6   Chapman, Larry, Lesch, Nancy, and Passas Baun, Mary Beth.   (2007)   the Role of Wellness Coaching in Company Wellness.   the Art of Wellness, July/August, 1-12.

7   Chapman, Larry.  (2007)   Proof Positive –   an Analysis of the cost-Effectiveness of Corporate Health Promotion.  Northwest Health Management Publishing, Seattle, WA.

8   Chapman, Larry.  (2007)   an In-Depth Look at the Economic Evidence for Rewarding Health Behavior Change.   Workshop presentation at the World Research Group “Rewarding Healthy Behaviors for Health Plans and Companys” Conference, Orlando, FL, January 23-24.

9   Edington, Dee.   (2001)   Emerging Research –   A View from One Research Center.  American Journal of Health Promotion 15(5) –  341-349.

10   Edington, Dee W.  (2007)   Health Management as a Serious Business Strategy.  Presentation at the World Research Group “Rewarding Healthy Behaviors for Health Plans and Corporations” Conference, Orlando, FL, January 23-24.

11   Pelletier, Barbara, Boles, Myde, and Lunch, Wendy.  (2004)  Changes in Health Risks and Make certain to work Productivity.   Journal of Occupational and Environmental Medicine, 46(7) –  746-754.

12   Pelletier, Kenneth R.  (2005)   A Review and Analysis of the Clinical and Cost-Effectiveness Studies of comprehensive Health and Disease ManagementPrograms at the Worksite –  Update VI 2000-2004.  JOEM 47(10)1051-1058.

13   DeVol, Ross, Bedroussian, Armen, et.  Al.  (2007)  an Unhealthy America –   the Economic Burden of Chronic Condition.  Report released by the Milken Institute.   www.milkeninstitute.org.

14   Partnership for Prevention.  (2008) Investing in Health –   Proven Wellness Practices for Workplaces.   http – //www.prevent.org/images/stories/2008/investinginhealth_finalfinal.pdf.

Over a hundred studies in both corporate and governmental settings have documented the economic advantages of staff member health promotion programs, including reduced absenteeism, reduced injuries and workman’s compensation costs, reduced healthcare costs, reduced staff member turnover, in addition to increased productivity, greater staff member satisfaction, and improved morale.1-10  

The more recent literature reflects improvements in wellness programming along with greater return on investment.  In general, the more focused and intensive the program, the greater benefit realized.  

To enhance their effectiveness federal government worker health promotion programs may  be able to incorporate some of the features described.  Employee health promotion programs shown to have positive returns on investment often include the following features –    

1   Health and productivity management model

Programs characterized by this model focus attention on identification and reduction of specific risks or behaviors like tobacco use, lack of exercise, excess weight, unhealthful diet, high cholesterol, high blood pressure, stress, depression, and so on.     

High-risk personnel are particularly targeted for intervention, although the most successful programs also direct efforts towards healthy personnel in order to maintain their low-risk status.  This model emphasizes outcomes as opposed to simply offering wellness activities for their own sake.     

2   Health risk (assessment|appraisal}

Use of a computerized health risk (assessment|appraisal}  instrument with individualized feedback and recommendations is nearly universal in successful programs.  Staff Members take the questionnaire annually in many cases.     

The Health Risk (Assessment|Appraisal} serves to increase awareness, provide direction, and motivate person to improve specific behaviors.  In some cases, the customized report is directly linked to appropriate resources related to identified risks.     

Research indicates that the use of an Health Risk (Assessment|Appraisal} is effective if it is followed by some kind of educational or therapeutic intervention for identified risks.  It often serves as the entry point into wellness programs.   

3   Biometric analysis

A lot of health promotion programs combine the results of the health risk (assessment|appraisal} with measurement of each worker’s biometrics, including weight and Body Mass Index (BMI) , blood pressure, cholesterol, fasting glucose, and assorted other metrics.     

Combining the results of the Health Risk (Assessment|Appraisal} with biological measures results in a more precise risk profile.   Computerized health risk (assessment|appraisal}s often incorporate biometric data in their risk analysis.   

4   Wellness Program Incentives

Staff Members are frequently given monetary or other significant rewards for completing an HRA, participation in a program or class, specific accomplishments like stopping smoking, losing weight, or exercising, and for maintaining healthy status and/or behaviors.     

In many cases the monetary incentives are associated with reductions in medical insurance premiums.  Some programs use disincentives in addition to incentives, such as charging personnel who smoke higher rates for their medical insurance contribution.   

5   High health promotion program participation rates

Successful programs use incentives to drive participation rates up.  They also market their programs comprehensively, and may use contest or challenge strategies to heighten enthusiasm and encourage participation.   

6   Wellness coaching

Employees with identified risks or desire to improve their health habits could  be periodically coached via telephone by trained wellness Coaches.     

Coaching assists workforce set and achieve realistic lifestyle-related goals including those addressing stress, work life balance, tobacco use, weight, physical activity, and various behavior modifications.     

Three or more sessions are typically offered.  In some intensive programs, the coaching extends to actual disease management (DM) intervention for workers with identified high-risk diseases.    

7   Multiple formats

Programs might offer wellness content in online, paper, and seminar formats to provide stimulating variety and alternatives for accommodate the needs of all staff.     

In addition to on-site physical activity and healthful eating events, on-line programs, e-mail reminders and notices, printed newsletters and materials, and workplace courses and seminars are common dissemination strategies.   

8   Upper management support

Enthusiastic and frequent endorsement by  upper management is vital to achieving high rates of participation.  When senior executives are wellness role models themselves the effects of endorsement are enhanced.   

9   Frequent contact

Successful programs have frequent contact of some sort with every worker.  This could  be through advertising and marketing efforts (e.g., posters, e-mail notices, reminders, or messages, etc.), bulletin boards, newsletters, staff meeting presentations, discussion in new worker orientation, supervisory sessions, etc.      

The key is to enhance employee awareness of wellness opportunities and reinforce the corporate emphasis on wellness through frequent and multiple “touches”.   

10   Open enrollment

To encourage high participation rates workers must have easy access to the wellness programs and activities.  Open and uncomplicated enrollment processes achieve this.     

Some corporations automatically enroll all staff and then allow those who don’t wish to participate to “opt-out”.  This practice has been shown to improve enrollment rates in some establishings.   

11   Family involvement

A lot of programs encourage spouses and other family members to take part in the company wellness activities and to adopt a healthy lifestyle along with the designated staff member.  It’s far easier for the staff member to have a healthy lifestyle if his/her family does so as well.   

12   Smoking cessation

Because tobacco use and other tobacco use is the number one threat to health it is critical to offer staff effective and convenient assistance with quitting.     

Access to tobacco cessation pharmaceuticals is often part of such programs.  In-house programs provide the most convenient access to these services, although on-line or telephone-based programs might  be available as well.     

13   Exercise

Regular exercise is a core component of every wellness program.  Employees ought to be strongly encouraged to engage in regular exercise.     

Most programs provide either periodic or continuous onsite opportunities, and some locations have onsite fitness clubs, swimming pools, walking trails, etc.  Discounted or paid memberships to community exercise facilities is a common alternative to onsite facilities.   

14   Weight management

Because obesity is a major threat to health it is very important that programs offer effective assistance with weight control.  Extensive encouragement from  upper-level management to shed excess weight is important.     

Online programs, worksite programs, or discounted access to weight control programs in the community may all be available.  Long-term follow-up is vital for maintenance of losing weight.   

15   Stress management

Workplace stress is perhaps the most common complaint among employees and a major contributor to absenteeism, presenteeism (reduced productivity), and low morale.     
   
Almost all successful health promotion programs offer assistance with personal and workplace stress.  Some programs refer staff to outside resources for more serious conditions like depression and anxiety disorders, but most offer web-based or frequent on-site general stress reduction programs.     
   
Some businesses endeavor to structure the work environment to minimize stress, both physically and operationally.   

16   Health screenings/immunizations

Staff Members are actively encouraged to complete recommended medical screenings for blood pressure, cholesterol, Body Mass Index, colorectal and breast cancer, and others.     

Annual influenza immunizations are also encouraged.  Some sites provide these services at the worksite.  Incentives are often awarded for completion of these screenings/immunizations.    

17   On-Site health care

Actual provision of on-site main care medical services is a growing trend.  The rapidly escalating costs of medical care insurance for employees has stimulated this trend.     

Some corporations have found that it is less costly to provide main care services themselves than to fund those services through health insurance.     

Onsite care also reduces the amount of time staff would otherwise spend away from the worksite getting such services.    

References   

1   Aldana, Steven G.  (2001)   Financial Impact of Wellness Programs –   A Robust Review of the Literature.   Am J Wellness 15(5) – 296-320.

2   Chapman, Larry.  (1998)   the Role of Incentives in Wellness.  The Art of Health Promotion  2(3) – 1-8.

3   Chapman, Larry.   (2003)   Biometric Screening in Wellness –   is it Really as Important as We Think?  the Art of Wellness  7(2) – 1-12.

4   Chapman, Larry.  (2005)   Meta-Analysis of Employee Health Promotion Economic Return Studies –  2005 Update.  The Art of Wellness, July/August, 1-15.

5   Chapman, Larry.   (2006)   Staff Member Participation in Employee Wellness and Wellness Programs –   How Important are Incentives, and Which Ones work Best?   North Carolina Medical Journal   67(6) –   431-432.

6   Chapman, Larry, Lesch, Nancy, and Passas Baun, Mary Beth.   (2007)   the Role of Health Promotion Coaching in Company Health Promotion.   the Art of Wellness, July/August, 1-12.

7   Chapman, Larry.  (2007)   Proof Positive –   an Analysis of the cost-Effectiveness of Corporate Wellness.  Northwest Health Management Publishing, Seattle, WA.

8   Chapman, Larry.  (2007)   an In-Depth Look at the Economic Evidence for Rewarding Health Behavior Change.   Workshop presentation at the World Research Group “Rewarding Healthful Behaviors for Health Plans and Employers” Conference, Orlando, FL, January 23-24.

9   Edington, Dee.   (2001)   Emerging Research –   A View from One Research Center.  American Journal of Wellness 15(5) –  341-349.

10   Edington, Dee W.  (2007)   Health Management as a Serious Business Strategy.  Presentation at the World Research Group “Rewarding Healthy Behaviors for Health Plans and Companys” Conference, Orlando, FL, January 23-24.

11   Pelletier, Barbara, Boles, Myde, and Lunch, Wendy.  (2004)  Changes in Health Risks and Be sure to work Productivity.   Journal of Occupational and Environmental Medicine, 46(7) –  746-754.

12   Pelletier, Kenneth R.  (2005)   A Review and Analysis of the Clinical and Cost-Effectiveness Studies of extensive Health and Disease Management (DM)Programs at the Worksite –  Update VI 2000-2004.  JOEM 47(10)1051-1058.

13   DeVol, Ross, Bedroussian, Armen, et.  Al.  (2007)  an Unhealthful America –   the Economic Burden of Chronic Disease.  Report released by the Milken Institute.   www.milkeninstitute.org.

14   Partnership for Prevention.  (2008) Investing in Health –   Proven Wellness Practices for Workplaces.   http – //www.prevent.org/images/stories/2008/investinginhealth_finalfinal.pdf.

Investigations may conclude that some interventions did not work well. You might find that a popular Health Promotion Program costs too much and did not really affect employees’ health.

While these might not be the outcomes you hoped for, without this information you may continue ineffective interventions. Having this information will help you develop better solutions.

When your results are good, it’s magnificent! You can spread the word to staff and management that your program is achieving its objectives.

Three major areas of an analysis

• Health Promotion Program structure – the basic framework of the program

• Wellness Program process – How well the program is run

• Health Promotion Program outcomes – Regardless of whether the program met the set goals

Common questions used to evaluate a Health Promotion Program

Structure Questions

• What’s included in the Health Promotion Program? What’s the intervention?

• Where does the Health Promotion Program take place?

• How is the Health Promotion Program delivered? What content is included?

• Who manages the Wellness Program?

Process Questions

• How many individuals  participate?

• Do participants complete the Wellness Program?

• Are participants satisfied?

• Which aspects of the Wellness Program are best attended?

Outcome Questions

• Does the Health Promotion Program improve understanding of health issues?

• Does the Wellness Program change behavior?

• Does the Health Promotion Program save the business money?

• What is the Return On Investment?

Download a sample program (http – //www.ibx.com/pdfs/custom/wellness_partners/services/turnkey_programs/walking/participant_eval.pdf) analysis from IBC’s Walking Towards Wellness program.

• Identify through an staff member survey what incentives they value.

• Identify what incentives the organization can provide in addition to what the budget will allow.

• Ensure that every participant who achieves a goal receives some recognition.

• Avoid offering incentives for the “best” or the “most.”

• Avoid using food as a reward.

• Use incentives to promote your health promotion program, through logos and branding.

Incentives can be used to elevate participation rates, help individuals complete a Health Promotion Program, or help individuals change or adhere to healthy behaviors.

Providing incentives and rewards will send an important message to the workers that your organization is committed to helping them with bettering their health. It also plays a meaningful role in motivating person to participate.

Tips on how to select appropriate incentives –

• Identify through an employee survey what incentives they value.

• Identify what incentives the organization can provide in addition to what the budget will allow.

• Ensure that every participant who achieves a goal receives some recognition.

• Prevent offering incentives for the “best” or the “most.”

• Avoid using food as a reward.

• Use incentives to promote your Health Promotion Program, through logos and branding.

It’ll be important to review and revise existing policies governing such areas as smoking sections and the staff cafeteria.

Tips on designing a Health Promotion Program –

• Create activities based on your plan objectives addressing the specific needs of your staff members. Focus on those topics that are of greatest interest to your staff members and the greatest needs of your organization, in that order. Avoid topics with narrow appeal.

• Keep it simple. Design the Health Promotion Program so it’s easy for the participants to understand and track.

• Integrate a combination of activities to include awareness, educational, and behavior elements.

• Pick activities in which every worker can participate.

Suggestions for your Health Promotion Program –

• Challenges. Activities that focus on practicing a desired behavior that continues for 4-8 weeks and focuses on specific topics (like exercise, nutrition, or stress management).

• Learning experiences. This includes seminars, videos, and classes.

• Behavior changes (like use of tobacco cessation). You may or might not offer interventions at the workplace. Notwithstanding, you should encourage person to make lifestyle changes that they want to make even without an external incentive.

• Education on illness management. for  instance, support and education groups for diabetes, high blood pressure, etc.

• Learing new skills. for  instance, CPR and first aid.

• Preventive screenings like blood pressure, cholesterol, and vision.