Unlocking the secrets to developing successful workplace health

Transcription

A Framework to Develop an Effective
Organization and Individual Behavior
Change Program
A
M
S
Michael P. O’Donnell, MBA, MPH, PhD
September 30, 2013
Alberta Health, Lake Louise
& his POSSE2
O
Michael P. O’Donnell, PhD, MBA, MPH © 2010
What Works Best
In Workplace
Health Promotion?
What Works Best
In Workplace Health Promotion?
Strategy to answer this question and develop the AMSO Framework
Systematic
l 
Benchmarking study
–  Good, very good, best
programs 76 ->26 ->6
l 
Background
l 
C Everett Koop Award
200 applications 1996-2012
–  Health impactß
–  Financial impact
Systematic literature
reviews
l  Composite reviews
–  Health impact of programs
–  1800+ manuscripts
384 studies
l  Design/manage programs
–  Financial impact of
–  100+ organizations
programs 72 studißes
–  10 years, 3 settings direct
l  Ongoing refinement
operations
l 
Monitor literature
Sampling of Theories
Not to mention the statistics!
HUH?
Individual level
l 
Learning Theories
l 
Information processing
l 
Health Belief Model
l 
Protection Motivation Theory; Extended Parallel
Process Model
l 
Theories of Reasoned Action, Planned
Behavior, and Integrated Behavior Model
l 
Goal-Setting
l 
Goal goal-directed behavior
l 
Automatic behavior, impulse behavior, habits
l 
Transtheoretical Model of Behavior Change
l 
Precaution Adoption Process Model and risk
communication
l 
Attribution Theory and Relapse Prevention
l 
Communication-Persuasion Matrix
l 
Elaboration Likelihood Model
Self Regulation
Interpersonal environment
l 
Social Cognitive Theory
l 
Stigma and Discrimination
l 
Diffusion of Innovation
l 
Social networks and social support
l 
Michael P. O’Donnell, MBA,MPH, PhD, © 2010
Multi-level
l 
Systems
l 
Power
l 
Empowerment
Organization level
l 
Stage Theory of Organization Change
l 
Stakeholder Theory
Community level
l 
Coalition Theory
l 
Social Capital Theory
l 
Social norms
l 
Conscientization
l 
Community Organization
Society and government level
l 
l 
l 
Agenda-building
Multiple Streams
Advocacy Coalition
Source: Bartholomew LK, Parcel GS, Kok G, Gottleib NH, Fernandez
ME, Planning Health Promotion Programs, 3rd 2011, Jossey-Bass
1
AMSO Framework Behavior Change
Program Investment Portfolio
AMSO Framework
A
Awareness
wareness
M
Motivation
otivation
Skills
S
5%
30%
25%
kills
O
Opportunity
40%
pportunity
Guestimate of Current Focus
40%
Awareness
Motivation
Skills
Opportunity
15%
35%
Dimensions of Opportunity:
Engaging the POSSE2
P:
O:
S:
S:
E:
E:
Peers
Organizations
State
Society
Environment
Equality
10%
Applying the AMSO Framework
Widely Adopted
l 
Critique existing program
Plan a new program
l  Help an individual change habits
l  Examine progress in your own life
l  Apply to large and small employers
l 
l 
l 
Many employers
Google real estate philosophy
l  Affordable Care Act, grants to small
business
Focus on the framework
Details will become intuitive
2
Trends in Prevalence (%) of No Leisure-Time
Physical Activity, by Educational Attainment, Adults
18 and Older, US, 1992-2007
2007
2006
2005
2004
1992
–  eg. tobacco use
All adults
2003
is the Impact of Awareness on
Behavior?
2002
l  What
Adults with less than a high school education
2000
Prevalence (%)
–  Link Between Behavior and Health Risks
–  Benefits of Healthy Lifestyle
60
55
50
45
40
35
30
25
20
15
10
5
0
1998
of Most Health Education
1994
l  Basis
1996
Awareness
Year
Note: Data from participating states and the District of Columbia were aggregated to represent the United
States. Educational attainment is for adults 25 and older.
Source: Behavioral Risk Factor Surveillance System CD-ROM (1984-1995, 1996, 1998) and Public Use Data Tape
(2000, 2002, 2004, 2005, 2006, 2007), National Center for Chronic Disease Prevention and Health Promotion,
Centers for Disease Control and Prevention, 1997, 1999, 2000, 2001, 2003, 2005, 2006, 2007, 2008.
Trends in Consumption of Five or More Recommended
Vegetable and Fruit Servings for Adults 18 and Older,
US, 1994-2007
Awareness
35
Prevalence (%)
30
25
24.2
24.4
24.1
24.4
23.6
24.3
24.7
20
15
l  Basis
of Most Health Education
–  Health Risk Factors
–  Benefits of Healthy Lifestyle
l  What
is the Impact of Awareness on
Behavior?
10
5
0
1994
1996
1998
2000
2003
2005
2007
Year
Note: Data from participating states and the District of Columbia were aggregated to represent the United
States.
Source: Behavioral Risk Factor Surveillance System CD-ROM (1984-1995, 1996, 1998) and Public Use Data Tape
(2000, 2003, 2005, 2007), National Center for Chronic Disease Prevention and Health Promotion, Centers for
Disease Control and Prevention, 1997, 1999, 2000, 2001, 2004, 2006, 2008.
l  Important
Role in Mobilizing Group Support
AMSO
Behavior Change Program Portfolio
Think about
your program
Awareness
Motivation
5%
30%
3
Enhancing Motivation
Embrace people as whole beings
Engage people in design and delivery process
l  Develop effective communication
l  Utilize extrinsic and intrinsic incentives
l  Provide effective leadership
l  Tailoring programs (Skill Building discussion)
l  Engage with health assessment
l 
Embrace People as Whole Beings
l 
Focusing on health risk usually does not work
l 
l  Embrace
people as whole beings
people discover their passions
l  Help people connect their passions with
health
l  Help people make plans to embrace their
passions and achieve their aspirations
through health
l  Help
l 
l  Motivational
Engage People in Processes
committees
research
l  Mentorships
l  Champions
l  Effective programs
interviewing approach
Develop Effective Communication
l  Wellness
l  Market
l  Confidentiality
l  Consistent
usually not by health educator
with corporate culture
l  Ubiquitous
& Transparency
Utilize Extrinsic and Intrinsic Incentives
Extrinsic (Financial) Rewards
- 
- 
- 
- 
l  Professional,
Can push participation from 20% to 90%+
Capture attention, increase participation
Limited long term impact on behavior
Danger of attributing behavior to the
financial incentive vs. the intrinsic benefits
Evolve to Intrinsic Rewards
-  Life priorities
-  Self image
-  Passions
-  Relationships
-  Quality of life
Incentives and whole program can be self funded through
health plan benefit design. Sec 2705 PPAACA.
Use of Financial Incentives for Health
Promotion (Large Employers)
2009
2011
2012
Participation
36%
54%
80%
Health
8%
19%
38%
Source: Towers Watson Staying@Work. 2011
4
Provide Effective Leadership
importance of programs
appropriate budget
l  Serve as active program champions
l  Be visible program participants
Engage with Health Assessment
l  Recognize
l  Health
l  Provide
l  Biometric
risk questionnaire
screenings
Understanding health risks does have some
impact. It motivates people because it helps
them understand the link between lifestyle and
health in a personal way.
AMSO
Awareness
Think about
your program
Motivation
Skills
30%
25%
Skill Building
More than Why and What to Change…
How, When, Where, With Whom and What If’s
l  Goal Setting
l  Tailoring
l  Utilizing the Best Science
l  Mastering New Behaviors
l  Integrating Behaviors into Life
5%
Goal Setting
l 
Doubles success rates
Expert guidance & personal buy in
l 
Aspirational, learning & performance goals
l 
5
Tailoring
l  Customized
Self Efficacy
solution for each person
l  Belief
l  Level
of self efficacy and behavioral efficacy
l  Preferred learning style
l  Genetic predisposition
l  Motivational readiness to change
l  Health status
l  Therapeutic dose
I can successfully perform
behavior
l  Predicts
–  Joining program
–  Completing program
–  Time to relapse
& transparency
Behavioral Efficacy
Focusing Efforts
Self Efficacy
Low
High
l  Belief
the behavior leads to desired
outcome
Low
Behavioral
Efficacy
High
Genetic Predisposition, Physical and
Mental Condition
–  Athletic ability and experience
–  “Runner’s High”
–  Weight
–  Addiction
–  Physical disability
–  Mental illness
Preferred Learning Style
by Lifestyle Topic
l  Print
l  Telephone
l  Web
l  Individual
face to face
l  Group
& transparency
6
Motivational Readiness to
Change
–  Precontemplation
–  Contemplation
–  Preparation
–  Action
–  Maintenance
–  Termination
Tailoring by Stages of
Motivational Readiness
l 
Never
40%
Later
40%
Soon
20%
Now
Trying to be forever
Probably forever
l 
l 
l 
l 
Therapeutic Dose
Tailoring
readiness to change
of self efficacy and behavioral efficacy
l  Preferred learning style
l  Genetic predisposition
l  Health status
l  Therapeutic dose
l  Level
Precontemplation
–  Unconditional acceptance
–  Indirect comments
Contemplation
–  Enhance Behavioral Efficacy
–  Enhance Self Efficacy
–  Expose Social Networks
–  Aspirational Goal Setting
Preparation
–  Learning Goal Setting
–  Enhance Self Efficacy
–  Enhance Behavioral Efficacy
–  Introduce to Social Networks
Action
–  Performance Goal Setting
–  Skill Building
–  Engage in Social Networks
Maintenance
–  Maintain Social Networks
–  Offer Leadership Opportunities
–  Reinforce Self Efficacy
–  Reinforce Behavioral Efficacy
l 
Provide sufficient intensity to make difference
–  Skill Building
–  All aspects of the program
•  Eg budget: $200-$250/person/year for workplace health promotion
program
& transparency
Tailoring
Utilize the Best Science
Readiness to Change
l  Level of Self Efficacy and Behavioral Efficacy
l  Preferred Learning Style (Skill Building)
l  Health Status
l  Therapeudic dose
& Transparency
7
Best Methods for Weight Control?
Best Science for Tobacco Treatment
l 
Meta-analyses of 27 different topics (hundreds of studies)
l  Combined approaches: Brief MD advice+ behavior therapy +
medication
l  Minutes of therapy: 300
l  Number sessions: 8
l  Type and number of staff: 2-3 including one physician
l  Medication type: outcomes by medication
l  Behavioral therapy type: outcomes by type
–  Moderate to vigorous
–  Activities of daily living
–  Reduced screen time and other sedentary time
l 
Nutritious sustainable diet vs. short term “fad” diet
l 
Self monitoring
l 
Eating less fat, exercising more, using prescription weight loss
medication, joining commercial weight loss program, NOT eating diet
products *
Intensive lifestyle change program
Bariatric surgery
?
?
?
–  Low calorie, low fat
–  Recording food consumption
–  Frequent weight measurement
l 
l 
l 
What success rate would you like?
l 
l 
Treating Tobacco Use and Dependence: 2008 Update, Fiore, et al, HHS
Increased physical activity
l 
*Nicklas, Am J Prev Med. May, 2012
Workplace Health Promotion
Overall Processes
What Works in Worksite Health Promotion: Systematic Review Findings
and Recommendations from the Task Force on Community Preventive
Services
Robin E. Soler, Nicholaas Pronk, Ron Goetzel
American Journal of Preventive Medicine
Volume 38(2) Supplement 2, February, 2010
Methodology
Search databases:
Medline, Employees Benefits,NTIS, Sports Information Resource Guide, Cambridge Scientific
Abstracts, Business Week, ABI Inform, Health Promotion and Education, Cumulative Index to Nursing
and Allied Health Literature, Office of Smoking and Health, AIDSLine, PsychInfo, and Sociological
Abstracts
Inclusion Criteria
1. 
Primary research in peer review journal or technical report
2. 
Published January 1980-June 2005
3. 
Meet research quality criteria
4. 
Evaluate impact of workplace health promotion program
5. 
Measure change in one or more outcomes of interest
Studies found
1. 
Abstracts and titles: 4,584
2. 
Studies examined in detail: 334
3. 
Studies meeting all criteria: 86
Ratings
The Community Guide
1. 
http://www.TheCommunityGuide.org/worksite
3. 
Focus of Review
l 
l 
Health Assessment with Feedback but No Skill Building
vs
Health Assessment with Feedback Plus Skill Building
2. 
Study design: threats to internal validity: greatest, moderate, least
Quality of execution: good, fair, limited
Effect size: quantitative, qualitative
Health Assessment with Feedback
but No Skill Building
Conclusion: Insufficient evidence to recommend
Reasons:
l  Small effect size
l  Small number of studies (32)
l  Poor study design
8
Health Assessment with Feedback Plus Skill Building*
Conclusion: Strong evidence of effectiveness
Tobacco use (30)
Dietary fat consumption (11)
Blood Pressure control (31)
Cholesterol management (36)
Absence from work (10)
- 1.5 % pp prevalence
- 4.8 mg/dl
- 1.2 days/year less
l 
l 
Conclusion: Sufficient evidence of effectiveness
Seat belt use (10)
Heavy drinking (9)
Physical activity (18)
Health risk score (21)
Medical utilization (7)
Mastering New Behaviors
- 2.3 % consumption
-15.3 % pp prevalence
l 
Conclusion: Insufficient evidence of effectiveness
Fitness (9)
Body composition (27)
- BMI (8)
- Weight (17)
- Fat (6)
positive outcomes
small effect sizes, multiple measures
-.5 BMI unit
-.56 pds
-2.2 %
consistent findings
small effect size
small effect size
Translating new skills into practice
Forming new habits
How long does it take for new skills to
become established habits?
Conclusion: Not effective
Fruit and vegetable consumption (8) minimal changes observed
*Numbers of studies are shown in parentheses ( )
Integrating Behaviors into Life
l 
l 
l 
Think about
your program
How to overcome barriers
How to overcome social influences
How to create opportunities
AMSO
Awareness
Motivation
Skills
Opportunity
5%
POSSE2: The Dimensions of Opportunity
Posse:
A large group with a common interest..Merriam Webster
Your crew, your hommies, people who sometimes have your back…Urban Dictionary
30%
25%
40%
P:
O:
S:
S:
E:
E:
Peers
Organizations
State
Society
Environment
Equality
9
P: Peers
Social Networks and Lifestyle
Most important influence group
- Close friends
- Close co-workers
Design: Framingham Heart Study; longitudinal
observational study
l  Sample: 12,067 people, 3 generations
–  53% women 47% men
–  21-70 years, mean 38
–  0-17 years of education, mean 13.6
l  Measures:
l 
–  Biometrics & health behaviors
–  Social connections
•  All 1st order relatives
•  At least one close friend
•  Neighbors
–  1973,1981,1985,1989,1992,1997,1999,2003
l 
Obesity, smoking, depression, alcohol
Christakis, NEJM, 357;4;2007
Probability That an Ego Will Become Obese According to the Type of Relationship with an
Alter Who May Become Obese in Several Subgroups of the Social Network of the
Framingham Heart Study
Probability That a Subject Will Quit Smoking According to the Type of Relationship with a
Contact Who Quits Smoking, in the Social Network of the Framingham Heart Study
Geographic separation
Effect maintained 0,.26,1.5,3.4,9.3,471 miles
Likelihood & degrees of separation
1: 45%
2: 20%
3: 10%
Christakis NA, Fowler JH. N Engl J Med 2007;357:370-379
O: Organizations
l 
Employer
– 
– 
– 
– 
– 
– 
Health promotion program
Smoke free campus, hiring smokers
Absenteeism, health plan, compensation
Nurturing vs. toxic mission and management
Safety hazards/protections
Cafeteria, walkable campus, fitness center
l 
Insurance Provider
l 
Faith Community
–  Norms, mission, messages
–  Access to programs
Schools, especially for families with children
Clubs
l  Others?
l 
l 
Employers need to leverage or overcome the influence of
other organizations
Christakis NA, Fowler JH. N Engl J Med
2008;358:2249-2258
S: the “State”
l 
National policy
– 
– 
– 
– 
– 
– 
– 
l 
State policy
– 
– 
– 
– 
l 
Agriculture, transportation, education, environmental policy
National campaigns: SBWG, national HP strategy
Support for health research
Integration of wellness into Medicare & insurance policy
Social safety net
Tobacco policy
38 provisions in the Affordable Care Act
Smoke free workplace laws, quitline coverage
Gun safety laws
Speed limits, helmet policies
Medicaid eligibility and scope of services
Local policy
– 
– 
– 
– 
– 
– 
Smoke free public places
Tobacco excise taxes
Restaurant ingredients & labeling
Local campaigns
Active transportation options
City planning, zoning, pollution control
Are you a passive citizen or a policy advocate? Your Organization?
10
Smoking Rates, Cleveland, Ohio & US, 2003-2009
30.0
S: Society, Celebrity Role Models
–  Oprah weight loss and gain
25.0
20.0
USA
Ohio-minus Cuyahoga
County
Cuyahoga County
15.0
10.0
5.0
Cleveland Clinic
- Smoke free campus, 2005
- Tobacco treatment program grant, 2006
- SmokeFreeOhio ballot initiative & excise tax, 2006
- Smoke Free Greater Cleveland, 2007
- Not Hire Smokers, 2008
0.0
2003
2004
2005
2006
2007
2008
2009
S: Society, Celebrity Role Models
–  Miss Universe Sushmita Sen (India), 1994
Baezconnde-Garbanati, AJHP, 2011
S: Society
l 
Broad cultural norms
– 
– 
– 
– 
l 
Ethnic norms
– 
– 
– 
– 
l 
Fitness & sports: 25,000 finished US marathon in 1976, 518,000 in 2011
Second hand smoke: annoyance in 1980, deadly in 2011
Smoke free workplaces: rare in 1980, the norm in 2011
Vegetarian diet
Expressing emotions
Significance of food
Asking for help and helping others
Eg. Cultural value of familismo, respeto, simpatia and personalismo
make Hispanic/Latino families want to protect their families from
second hand smoke BUT reluctant to ask neighbors to refrain from
smoking
Celebrity role models
– 
– 
– 
– 
Oprah weight loss and gain
Starlets pursuit of perfect body
Actors smoking in movies
Miss Universe Sushmita Sen (India), 1994
Be prepared to harness or overcome these influences
E: Environment
l 
Access to smoke free clean air
–  At work
–  Restaurants
–  Public spaces
l 
Access to nutritious affordable food
–  Cafeteria at work
–  Neighborhood stores
l 
Opportunities for physical activity
– 
– 
– 
– 
Building design: stairs vs. elevators
City to city comparisons
Neighborhood within cities
Active transportation
11
12
13
Opportunity
l 
Genetic Predisposition, Physical and
Mental Condition
–  Athletic ability
–  “Runner’s High”
–  Weight
–  Addiction
–  Physical disability
–  Mental illness
Walking
l  150
lbs person
mile a day
l  5 lbs not gained a year
l  50 lbs a decade
l  Half
Source: Active Living Research
Active Living & Physical Activity
Sprawl/connectivity between cities
Mixed use zoning within cities
l  Active transportation
l  Building design
l 
The Impact of Sprawl on
Health and Behavior
Between Cities
l 
Urban Sprawl
Ø  Utilitarian
Ø  Leisure
walking
time
walking
Ø  Increases
BMI: 6.2
lbs
Ø  Increases in BP
Source: Ewing et al. (2003) AJHP
14
The Effect of Mixed Use on Obesity
Within the Same City
A national study of US adolescents (N=20,745)* found a greater number of
physical activity facilities is directly related to increased physical activity
and inversely related to risk of overweight
l 
l 
l 
Participants were divided into
four groups based on the
level of land use mix
Each quartile increase in land
use mix was associated with
a 12.20% reduction in the
odds of being obese.
The difference in weight for
an average 5’ 10” white
males in the lowest quartile of
mixed use and the highest
quartile of mixed use was 10
pounds.
Frank, L., Andresen, M., and Schmid, T., Obesity Relationships With Community Design, Physical Activity, and Time Spent in Cars.
American Journal of Preventive Medicine. June 2004.
Odds ratio
1.5
Odds of having 5 or more bouts of MVPA 1.25
1.26 Referent 1
0.75
Odds of being overweight .68 0.5
One
Two
Three
Four
Five
Six
Seven
Number of facilities per block group
*using Add Health data Gordon-‐Larsen P, Nelson MC, Page P, Popkin BM. Inequality in the built environment underlies key health dispariAes in physical acAvity and obesity. Pediatrics 2006; 117(2): 417-‐424. hMp://www.pediatrics.org/cgi/content/full/117/2/417 A study of 33 California ciAes found that adults who drove the most had obesity rates (27%) that were three Ames higher than those who drove the least (9.5%). Lopez-‐ZeAna J, Lee H, Friis R. The link between obesity and the built environment. Evidence from an ecological analysis of obesity and vehicle miles of travel in California. Health & Place 2006; 12(4):656-‐664. Michael P. O’Donnell, MBA,MPH, PhD, © 2010
15
Using the stairs
l  150
lbs person
l  4 minutes a day
l  3 lbs not gained a year
l  30 lbs a decade
16
Natural Environment
Environment
Will you choose your environment?
Santa Cruz: body surfing & cycling
l  Michigan: indoor swimming & X country
skiing
l  Seoul: hiking in the mountains
l  Pittsburgh: crew
l 
Will you shape your environment?
Or
Will your environment shape you?
Opportunity
E2: Equal Opportunity
Equality/Inequality
l  Access
to social, financial resources
–  Absolute: Basic poverty/wealth level
–  Relative: Difference between rich and poor
l  Inspired
by work of Richard Wilkinson and
Kate Pickett of the Equality Trust in the UK
Health Effects of Inequality
Documented Health Outcomes
l 
l 
l 
l 
l 
l 
l 
l 
l 
l 
l 
l 
l 
l 
l 
l 
Mortality
–  Infant mortality
–  Life expectancy
–  Disability free years
Self reported health
Mental health
Injury accidents, violence
Cancer
Circulatory disease
Physical inactivity
Smoking
Obesity
Alcohol and drug abuse
Homicide, suicide
Diabetes
Causes
l 
l 
l 
l 
l 
l 
l 
l 
l 
l 
l 
Behavior
Food access
Medical access
Housing, neighborhood
Education
Water and air pollution
Social networks
Distress from exclusion
Unemployment
Professional role models
Quality of work
HIV/AIDS
Coronary artery disease & stroke
Pre-term birth
Adolescent pregnancy
Causes of the Causes:
Accumulation of Effects Across Life
l 
l 
l 
l 
l 
l 
l 
l 
l 
Maternal health
–  Stress, debt, alcohol & tobacco use
Fetus In utero
–  Birth weight, brain development
First year of life
–  Cognitive development
Early years
–  Physical, cognitive, social development
–  School readiness, educational attainment
School performance
College attendance
Educational outcome and professional readiness
Career opportunities
Ultimate social status
17
Social Evaluative Threat
may be the underlying cause
Inequality causes people to judge themselves negatively relative to other
people
Social evaluative threat triggers release of cortisol and pro-inflammatory
cytokines.
Cortisol impedes immune functions, increases the risk of heart disease, and
threatens other physiological systems.
Chronic inflammation has been linked to increased rates of autoimmune
disorders including rheumatoid arthritis, lupus, and polymyalgia
rheumatica; asthma; the inflammatory bowel diseases ulcerative colitis
and Crohn's disease; cardiovascular disease; bacterial endocarditis;
cancer; urinary infections; and cystitis, and may increase the risk of a
squamous cell bladder cancer.
Defending one's honor becomes more important, and can lead to physical
injuries caused by fighting and the additional stress caused by hostile
interactions.
Importance of maintaining status increases the social pressure to divert
limited financial resources from food, rent, utilities, medical care, and
other necessities of basic living that will preserve good health to buying
nice clothes, cars, toys for kids, or entertainment to raise status, or to
drugs, alcohol, or cigarettes to help cope with the stress.
Multiple Levels of Impact of
Inequality
l  Organization
l  Neighborhood
l  City
l  State
l  Nation
E2: Equality
l 
Inequality hurts both the most deprived
individuals and the whole population in which
inequality exists
l 
When inequality is high in your state, community
or organization, be prepared to provide more
support/spend more money for the same
outcome
l  Most deprived individuals
l  Whole population
OR
Work to reduce inequality in areas under your
control
l 
Think about
your program
18
AMSO
Awareness
Motivation
Skills
5%
40%
l 
Think of a behavior or health issue you or associate
“should” be addressing but are not
Clarify role: Active listener or stalled changer
Reflect on why you are not addressing it
– 
– 
– 
– 
Peers
Organizations
State
Society
Environment
Equality
What is stalling change
at a personal level?
l 
P:
O:
S:
S:
E:
E:
30%
25%
Opportunity
l 
Dimensions of Opportunity:
Engaging the POSSE2
Lack of Awareness
Lack of Motivation
Lack of Skills
Lack of Opportunity
How well does your program help
your employees improve?
Think about a health behavior or condition that has not
improved very well through your wellness program
l  Clarify role: Active listener or program analyzer
l  Review how you scored your program on AMSO Framework
l  Discuss areas that you would like to improve your program
l 
–  What changes would have the most impact?
–  What changes are you most able to change?
–  What is your plan for areas with greatest impact that you are able
to change?
AMSO & HIS POSSE2
Awareness
Motivation
Skills
Opportunity
5%
30%
Thank You
25%
40%
FOCUS ON THE FRAMEWORK
19
Discussion
20

Unlocking the secrets to developing successful workplace health

Transcription

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