Barriers to Health: Northwoods LEAN Presents. Identifying and Addressing Obstacles to Achieving Worksite Wellness in Rural Wisconsin

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1 Facilitated by Oneida County Health Department Northwoods LEAN Presents Barriers to Health: Identifying and Addressing Obstacles to Achieving Worksite Wellness in Rural Wisconsin 2014

2 Background Northwoods LEAN (Linking Education, Activity, and Nutrition) is a chronic disease prevention and management coalition that serves Oneida and Vilas Counties in Northern Wisconsin. In efforts to improve the health of these communities, specifically though worksite wellness, the Oneida County Health Department, in partnership with Northwoods LEAN, conducted focus groups in local businesses to obtain information regarding barriers to health. Limitations Because participation in the focus groups was voluntary, this report is missing the opinions of employees who were unwilling to take part. It is unknown if these non-participants have different barriers to getting and staying healthy, but it is noted here as a limitation in the focus group data.

3 Method Several large worksites/employers in Vilas and Oneida counties were selected for participation in focus groups. The five groups included retail, real estate, education, manufacturing and healthcare. Fifty-six people voluntarily participated: Retail Education Manufacturing Real Estate Healthcare The focus group moderator, with Oneida County Health Department (OCHD), developed a list of topic areas and questions for discussion. The topic areas below were selected to reflect overall barriers to health, wellness, and safety. Seasonal Transportation Time Geographical Familial Physical Financial Participant recruitment was facilitated by both management and the moderator. Focus group design ideally allows for no more than ten participants and when applicable, supervisors and supervisees were not placed in the same group so all participants could speak freely. In most groups, the topic areas above were written on a poster board and introduced as springboards for discussion about barriers to getting and staying healthy. Twenty-three of the fiftysix participants were willing to provide the information found in Table 1.

4 Recommendations Areas of Concern Health Barrier Mental Health Fitness Nutrition -General stress -Fatigue -General time pressures -Too many responsibilities -Being caregivers to children/adults -Fatigue -Motivation -Lack of peer support or friends to exercise with -Hours of operation of the fitness facility, especially for parents of school-age children -Culture of fried/unhealthy foods as "fun" -Limited selection of fresh seasonal foods -Confusing array of websites and the inability to filter information -Having enough money for healthy food -Stress management training -Parenting skills classes -Supervisor training programs -Time-management skills training -Individualized behavioral change programs -Worksite nutrition programs -Worksite physical activity programs -Offering healthy food items -Providing reliable nutritional information Mental Health -Stress-management training affects quality of work life and complaints -Parenting skills classes improve parents' mental health -Supervisor training programs improve supervisory skills, work environment and employee retention -Several participants requested time-management skills training As shown below, stress is a very common barrier to health

5 Wellness Programs Health Care Ergonomics -Not having peers to exercise with -Judgment from other workers about taking part -Modesty about publically taking part in a "Biggest Loser" type program -Lack of motivation -Lack of readily available primary care and specialist health care providers in the region -Providers' schedules are too busy for them to consistently see their own patients -This was a minor issue in workers health -Offer on-site fitness opportunities -Set up incentive-based programs -Set up programs with strong social support -Encourage physical activity breaks -More readily available primary care and specialist health care providers -Providers with more flexible schedules -This was a minor issue in workers health Fitness -Individualized programs focused on changing behavior (example: parking farther from the entrance to work), setting goals (stretching daily), tracking progress and building social support increase physical activity and fitness -Professionally-guided programs appear to have more consistent results Nutrition -Worksite nutrition and physical activity programs increase physical activity, weight loss, and fruit and vegetable consumption among employees -Worksites can offer employees healthy foods and provide healthy eating reminders and reliable nutritional information

6 Wellness Programs -Offer on-site fitness opportunities such as group classes or personal training -Set up programs that have cash incentives or reduced insurance costs for participation -Set up programs that have strong social support systems and incentives, such as team physical activity goals -Support physical activity breaks during the workday such as stretching or walking Health Care -The focus group discussion revealed the lack of readily available primary care and specialist health care providers in the region as a barrier to seeking care -When people choose providers, they often cannot schedule time with that person because providers' schedules are too busy for them to consistently see their own patients Ergonomics/Safety at Work -Worksite ergonomics and injuries are minor issues in workers' health and wellbeing based on the responses of those involved in the focus groups

7 Conclusions Worksite wellness programs, whether large or small, complex or simple, can include "health education classes, subsidized use of fitness facilities, internal policies that promote healthy behavior and any other activities, policies or environmental changes that affect the health of employees" and are a good return on investment. C o s t The average cost/benefit ratio for wellness programs based on a summary of 28 articles was $3.48 saved per $1 invested (Aldana, 2001). B e n e f i t "Program returns range from two to ten times the cost of the program when important factors such as health care costs and productivity are evaluated. There are ways for even small employers to make positive changes at little or no cost." Research from June 2014 shows that "well-designed and properly targeted employersponsored health promotion programs produce substantial savings" (Goetzel et al, Health Affairs, 33:8, June 2014). The Worksite Wellness Resource Kit, developed by the Wisconsin Department of Health Services is a free source of many types of wellness program ideas. Resources -( -(What Works in Worksites, Worksitepdfs/WWworksites.pdf) -(

8 About the Oneida County Health Department and Northwoods LEAN Oneida County Health Department has achieved national accreditation through the Public Health Accreditation Board (PHAB). The national accreditation program works to improve and protect the health of the public by advancing the quality and performance of the nation s Tribal, State, Local, and Territorial public health departments. Vision Oneida and Vilas County residents will live in a community that promotes and supports residents in achieving a healthy lifestyle across the lifespan. Mission Northwoods LEAN is a coalition that promotes a culture of healthy living through physical activity and nutrition in Oneida and Vilas Counties. Telephone (715) Oneida County Health Department 100 West Keenan Street Rhinelander, WI 54501