About the Playbook
Pillars of Workplace Health
Based on the latest research, AHA scientists have consolidated key elements of effective workplace health and well-being programs into seven pillars. AHA partnered with leading workplace health expert Dr. Ron Goetzel and his team at the Johns Hopkins University Bloomberg School of Public Health to outline current best practices within each pillar. In addition, AHA has punctuated this guidance with realworld case studies from AHA’s CEO Roundtable companies, and information about Life’s Simple 7, AHA’s prescription for heart health.
Johnson & Johnson’s Healthiest Workforce Commitment
“Caring for the world, one person at a time” has inspired Johnson & Johnson for over 125 years. With 128,000 employees in 60+ countries, Johnson & Johnson is the world’s largest, most diverse healthcare company, touching the lives of more than a billion people every day.
Caring for employee health and well-being is central to Johnson & Johnson’s company culture, demonstrated through its commitment to employee wellness for over 100 years. Johnson & Johnson is a forerunner in creating a Culture of Health, which is cultivated by a global environment that supports healthy choices, provides innovative programs and initiatives and takes a holistic approach that includes mental, emotional and physical well-being to drive and sustain better health and wellness. At Johnson & Johnson, it starts with active leadership support and participation beginning with the CEO, and is carried throughout the organization with the support of Health Champions who lead by example and ensure that employee health is part of the business agenda. Health Champions are part of a network of positive influencers who can provide leadership as well as strategic and practical support. With the help of these champions, Johnson & Johnson is able to foster an environment where wellness isn’t a program or offering, but a core value.
Johnson & Johnson continually applies new and innovative approaches to help achieve the company’s vision of having the healthiest employees in the healthiest company for years to come. In 2010, the Johnson & Johnson Executive Committee launched Healthy Future 2015, outlining enterprise-wide goals. These goals drive program development and participation at all levels within the organization, and progress against each of the goals is reported externally on an annual basis. Leadership commitment includes publically setting and communicating health goals that are part of the Healthy Future 2015 sustainability goals.
Johnson & Johnson’s Vision for a Healthy Employee
Individuals who actively invest in their health and well-being to achieve their own personal best; they achieve balance in body, mind and spirit, igniting full engagement and purpose at work, at home and in their communities. Additionally, they work in an environment that fosters and supports healthy choices.
Goal 1: Improve access to culture of health programs
To support a Culture of Health, Johnson & Johnson established a 12-program framework that provides core essential elements across all locations, while permitting customization according to location, culture and local health risks. Since lifestyle changes are deeply rooted in personal choice and behaviors, Johnson & Johnson is creating an environment that will further cultivate the right choices. This goal aims to provide employees across the globe access to a rich and fully implemented set of health programs and services that are centered on Prevention, Protection and Performance.
Prevention programs aim to keep employees healthy, via preventative services, innovation and education. Some examples include:
- TOBACCO FREE worksite and support for those who want to quit the use of tobacco products2
- HEALTH ASSESSMENT to help employees know their key health numbers and risks
- EMPLOYEE ASSISTANCE PROGRAMS (EAP) access to confidential, professional counselors that support mental health and well-being
- PHYSICAL ACTIVITY movement opportunities such as gyms, walking trails and exercise classes
- HIV/AIDS POLICIES AND PROGRAMS providing a nondiscriminatory work environment in regards to HIV/AIDS status, with access to confidential testing and treatment
- EDUCATION/AWARENESS of how to prevent chronic diseases, providing choices and education around healthy foods on site and for catered meetings and creating understanding of preventative causes of and appropriate screenings for cancer
Protection programs and services are those designed to keep employees safe through compliance with regional regulations and adherence to Johnson & Johnson’s standards and quality care. Some examples include:
- ON-SITE SERVICES to provide general first aid and work-related injury/illness care and follow up
- TRAVEL HEALTH for the business traveler, with health services and health care access
- MODIFIED DUTY to assist employees to return to work and wellness after an illness or injury
- MEDICAL SURVEILLANCE exams and check-ups to ensure you remain safe and healthy while on the job
Performance programs link good health and well-being to high performance.
Some examples include:
- STRESS PREVENTION/RESILIENCY TRAINING training available upon request to help employees deal with stress in a positive way
- WORK LIFE BALANCE programs that respect the need for flexibility in when, where and how employees work, providing resources to meet work, family and personal responsibilities
- ENERGY FOR PERFORMANCE IN LIFE a program designed to help employees manage and maximize their energy to achieve balance in body, mind/emotion and spirit
Goal 2: Increase employee participation in Health Risk Assessments
Recent research conducted by AHA and Nielsen suggests that many employees across America do not know their numbers for key measures of health, like blood pressure or cholesterol. This may make it more difficult for these individuals to accurately assess their health, set health goals and make simple behavior changes – like being more active and monitoring blood pressure – to achieve them. Johnson & Johnson seeks to ensure that every employee has the ability to voluntarily participate in a personal health risk assessment. By “knowing their numbers” in context of their lifestyle habits and health risk scores, employees can face their personal truth and reflect on the changes that need to be made that are unique to their situation.
Goal 3: Increase the percentage of employees that are “low” health risk
As a result of activities supporting its first two goals, Johnson & Johnson has made great progress in improving employee health. Johnson & Johnson defines employees with “low” health risks as those who have 0-2 health risks as derived from the Health Assessment.
Since 2010, Johnson & Johnson has made great progress toward meeting its Healthy Future 2015 goals.
|Results as of September 2015|
90 percent of employees have access to Culture of Health (COH) programs
|90 percent of all employees have access to all 12 fully implemented COH programs
80 percent of employees have completed a health risk assessment and “know their numbers”
|87 percent of all employees (unique participants) have completed a health assessment
80 percent of assessed population is considered “low” health risk
|Data not available until early 2016|
The future focus for Johnson & Johnson is to continue to foster a workplace with an environment that encourages healthy choices and enables employees to achieve their personal best at work, home and in the community.
- Johnson & Johnson. 2014 Citizenship & Sustainability Report. (2014). at
- American Heart Association. Tobacco Control in the Workplace. (2015). at www.heart.org/playbook
- Lloyd-Jones, DM et al. Prediction of Lifetime Risk for Cardiovascular Disease by Risk Factor Burden at 50 Years of Age. Circulation. 2006; 113: 791-798. doi: 10.1161/CIRCULATIONAHA.105.548206.
- Ford ES, Greenlund KJ, Hong Y. Ideal cardiovascular health and mortality from all causes and diseases of the circulatory system among adults in the United States. Circulation. 2012;125:987–995. doi: 10.1161/ CIRCULATIONAHA.111.049122.
- Goetzel RZ, Pei X, Tabrizi MJ, Henke RM, Kowlessar N, Nelson CF, Metz RD. Ten modifiable health risk factors are linked to more than onefifth of employer-employee health care spending. Health Aff (Millwood). 2012;31:2474–2484. doi: 10.1377/hlthaff.2011.0819.
- Spring B, Ockene JK, Gidding SS, Mozaffarian D, Moore S, Rosal MC, Brown MD, Vafiadis DK, Cohen DL, Burke LE, Lloyd-Jones D; American Heart Association Behavior Change Committee of the Council on Epidemiology and Prevention, Council on Lifestyle and Cardiometabolic Health, Council for High Blood Pressure Research, and Council on Cardiovascular and Stroke Nursing. Better population health through behavior change in adults: a call to action. Circulation. 2013;128:2169–2176. doi: 10.1161/01. cir.0000435173.25936.e1.
The American Heart Association’s Smoke-Free Meeting Policy
With more than 3,000 employees and 156 offices nationwide, the American Heart Association (AHA) is the nation’s oldest and largest voluntary organization dedicated to fighting heart disease and stroke. AHA’s mission is to build healthier lives, free of cardiovascular diseases and stroke. That single purpose drives all the association does, including funding innovative research, fighting for stronger public health policies and providing critical tools and information that save and improve lives.
AHA also plays an active role in the federal legislative and regulatory arenas, including promoting policies that prevent and reduce tobacco use and protect non-smokers from exposure to secondhand smoke (SHS). The American Heart Association was a leading advocate for the landmark 2009 Family Smoking Prevention and Tobacco Control Act, which for the first time granted the Food and Drug Administration (FDA) the authority to regulate the manufacture, distribution, sale, labeling, advertising and promotion of tobacco products to protect public health. AHA’s state and federal advocacy activities continue to prioritize the reduction and prevention of tobacco use on numerous fronts: comprehensive smoke-free laws, tobacco excise taxes, increased funding for tobacco cessation and prevention programs, FDA regulation of newer tobacco products like e-cigarettes and evidence-based tobacco cessation coverage in private/public healthcare plans.
MACY’S ANNUAL 5K RUN/WALK
Macy’s, Inc. is one of America’s premier retailers. With fiscal 2014 sales of $28.1 billion, the company operates more than 880 stores in 45 states, the District of Columbia, Guam and Puerto Rico under the names Macy’s, Bloomingdale’s, Bloomingdale’s Outlet and Bluemercury, as well as the macys.com, bloomingdales.com and bluemercury.com websites. Macy’s diverse workforce includes approximately 166,900 employees, located across the country.
Macy’s believes good health begins with knowledge, making smart choices and practicing preventive care. Macy’s offers the Live Healthy program to help all its associates be as healthy as possible. At Macy’s locations across the country, associates are encouraged to Live Healthy every day. As part of Live Healthy, Macy’s sponsors programs, many including incentives, such as “Know Your Numbers” screenings, lifestyle coaching, disease management and tobacco cessation programs, flu shot clinics, wellness challenges and much more. In addition, Macy’s Healthy Choices medical options offer free preventative care coverage to enrolled associates and their families – as well as a 24/7 nurse line to answer questions any time, day or night. In recent years, Macy’s introduced a 5K Run/Walk as part of its Live Healthy Program.
KKR’s First Aid Training
KKR is a leading global investment firm that manages investments across multiple asset classes. KKR aims to generate attractive investment returns by following a patient and disciplined investment approach, employing world-class people and driving growth and value creation at the asset level. Core to KKR’s values is the belief that thoughtful management of environment, social and governance issues is smart business and an essential part of long-term success.
With more than 1,200 employees, consultants and advisors around the world, KKR is committed to fostering an internal culture of health and wellness. Launched in 2011, KKR Wellness Works is a health and wellness platform that engages KKR’s employees in a variety of ways. Core to KKR Wellness Works is the idea that employees who know their key health indicators are able to make better decisions for their health and ultimately improve their well-being. KKR provides annual incentivized biometric screenings to its employees, as well as resources to help employees better understand and respond to their results. Throughout the Wellness Works program, employee privacy is of utmost importance.
- Centers for Disease Control and Prevention. Healthier Worksite Initiative: Needs Assessment 101. (2010). Available at http://www.cdc.gov/nccdphp/dnpao/hwi/programdesign/needsassessment101.htm
- Partnership For Prevention. Worksite Health – Healthy Workforce 2010 and Beyond. http://www.prevent.org/Topics.aspx?eaID=1&topicID=52. Accessed September 17, 2015.
- Blank, G. Conducting A Focus Group. Available at http://www.cse.lehigh.edu/~glennb/mm/FocusGroups.htm
- Eliot & Associates. Guidelines for Conducting a Focus Group. (2005). Available at https://assessment.trinity.duke.edu/documents/How_to_Conduct_a_Focus_Group.pdf
- Centers for Disease Control and Prevention. Healthier Worksite Initiative: Program Design: Wellness Committees. (2010). Available at http://www.cdc.gov/nccdphp/dnpao/hwi/programdesign/wellness_committees.htm
- Centers for Disease Control and Prevention. Workplace Health – Planning/Workplace Governance – Structure and Management. (2013). Available at http://www.cdc.gov/workplacehealthpromotion/planning/structure.html
- Mattke, S., Schnyer, C. & Van Busum, K. R. A Review of the U.S. Workplace Wellness Market. Rand Health, Sponsored by the U.S. Department of Labor and the U.S. Department of Health and Human Services (2012). Available at http://www.rand.org/pubs/occasional_papers/OP373.html
- Taitel, M. S., Haufle, V., Heck, D., Loeppke, R. & Fetterolf, D. Incentives and Other Factors Associated With Employee Participation in Health Risk Assessments: J. Occup. Environ. Med. 50, 863–872 (2008).
- Seaverson, E. L. D., Grossmeier, J., Miller, T. M. & Anderson, D. R. The role of incentive design, incentive value, communications strategy, and worksite culture on health risk assessment participation. Am. J. Health Promot. AJHP 23, 343–352 (2009).
- Volpp, K. G., Asch, D. A., Galvin, R. & Loewenstein, G. Redesigning Employee Health Incentives — Lessons from Behavioral Economics. N. Engl. J. Med. 365, 388–390 (2011).
- Seifert, C. M. & Hart, J. K. in Health Promotion in the Workplace, 4th Edition (ed. O’Donnell, M. P.) (American Journal of Health Promotion, 2014).
- Consensus Statement of the Health Enhancement Research Organization, American College of Occupational and Environmental Medicine, American Cancer Society and American Cancer Society Cancer Action Network, American Diabetes Association & American Heart Association. Guidance for a reasonably designed, employer-sponsored wellness program using outcomes-based incentives. J. Occup. Environ. Med. Am. Coll. Occup. Environ. Med. 54, 889–896 (2012).
- Towers Watson/National Business Group on Health. Employer Survey on Value on Purchasing Value in Health Care. Towers Watson. Available at http://www.towerswatson.com/en-US/Insights/IC-Types/Survey-Research-Results/2012/03/Towers-WatsonNBGH-Employer-Survey-on-Value-in-Purchasing-Health-Care
- Kaspin, L. C., Gorman, K. M. & Miller, R. M. Systematic Review of Employer-Sponsored Wellness Strategies and their Economic and Health-Related Outcomes. Popul. Health Manag. 16, 14–21 (2012).
- Homish, G. G. & Leonard, K. E. Spousal influence on smoking behaviors in a US community sample of newly married couples. Soc. Sci. Med. 61, 2557–2567 (2005).
- Cobb, L. K. et al. Abstract P275: Physical Activity Among Married Couples in the Atherosclerosis Risk in Communities Study. Circulation 131, AP275–AP275 (2015).
- Johnson & Johnson Human Performance Institute. Using Science to Increase Energy & Enhance Leadership Output. (2015). Available at https://www.hpinstitute.com/why-hpi/our-science
- Strecher, V. On Purpose. (2015). Available at http://www.dungbeetle.org/
Engagement is More than Participation
Although the above advice focuses mainly on program participation, true engagement involves much more. You can think of engagement as a two-step process: first, getting your employees to participate, and then getting employees engaged on a deeper, more personally meaningful level. This can be accomplished by aligning your program with workers’ individual sense of purpose and life mission. Connecting your health promotion program’s goals with your employees’ purpose, beliefs and values will help maximize both program impact and personal engagement.17 The importance of finding and pursuing a personal purpose in life inspired University of Michigan professor Vic Strecher to investigate the integral role “purpose” plays in encouraging people to lead a healthier lifestyle.18 Connecting the program with employees’ sense of purpose will not only boost program participation, it will motivate employees to achieve improved health and well-being on a much deeper level.
Boston Scientific’s Worksite Wellness Pilot Program:
Building a Culture of Health On-Site
Boston Scientific is dedicated to transforming lives through innovative medical solutions that improve the health of patients around the world. A leading creator of medical products and technologies, Boston Scientific has approximately 24,000 employees around the globe and more than 11,000 employees across the United States.
As a global healthcare company, Boston Scientific’s commitment to improving patient health is clear. The company also believes there is an implied need to foster a culture of health and well-being for its own employees that allows them to work and perform at their personal best. For Boston Scientific, this concept of well-being reaches far beyond physical health, but focuses on a more holistic view of the work-life connection that ultimately can improve employee lives while elevating work productivity.
As with most global companies, Boston Scientific’s approach to well-being varies by geography and cultural norms at each site, but the overall philosophy and goals remain the same. Their philosophy includes continuous evaluation, measurement and improvement to ensure they’re meeting the needs of their employees.
Worksite Wellness Pilot Program: Creating On-Site Connections to Complement Virtual Resources
In 2013, Boston Scientific introduced a two-phased, on-site Worksite Wellness pilot program to address prevalent health conditions (e.g., physical inactivity, hypertension and stress) and raise employee awareness of the free resources available to them—like blood pressure monitoring stations, fitness centers, healthy food option labeling in the cafeterias and Employee Assistance and Health Improvement Programs. The pilot program was designed to focus on three health conditions identified as prevalent among the employee population: physical inactivity/being overweight, elevated blood pressure and stress.
The Worksite Wellness pilot program was initiated at two U.S. sites that captured nearly 50 percent of the Boston Scientific U.S. employee population, approximately 4,555 people. In total, more than 700 employees participated in the program. The key differentiator between the pilot program and Boston Scientific’s existing telephonic/web-based wellness program was that the pilot program incorporated on-site interventions, enabling the company increased communication with employees and opportunities to build a culture of health within the workplace. For example, the pilot incorporated a Worksite Wellness Champion Program, which engaged employees to serve as both the voice of their peers and as promoters of the programs being offered at their worksites. Boston Scientific kicked off the pilot with a four-day on-site campaign themed It’s Your Choice, which educated employees about new and existing worksite wellness programs available to them. In addition, the company engaged senior leadership at these locations to provide encouragement and support engagement.
Over the course of the pilot, Boston Scientific employed a full agenda of activities to promote, educate and reinforce the benefits of the available programs. Activities included 45-minute workshops like Every Choice Counts, Balanced Eating and The Silent Threat: Lifestyle Management of Blood Pressure; 20-minute skill building sessions like how to read food labels or do yoga at your desk; and 15-minute one-on-one consultations. Employees were most interested in programs pertaining to weight management, blood pressure management and stress management. Boston Scientific aimed to make all activities relevant, targeted, accessible and engaging to ensure greatest success.
Measuring Impact: Awareness, Participation, Health and Culture
Boston Scientific measured pilot program results via a number of mechanisms. Through employee feedback surveys, the company was able to measure increased awareness of resources. In addition, on-site events resulted in over 700 unique participants across offerings, a 93 percent satisfaction rate and 75 referrals into telephonic coaching programs (25% of participants engaged with a coach following the event). A single challenge for weight management resulted in:
Boston Scientific has also identified important and lasting improvements to its culture of health. Employees, champions and leaders from local resources (fitness centers, cafeterias and the on-site clinics) were able to form relationships that are still in place and enhanced today. Stress, a previously sensitive topic at the workplace, is now a topic that employees discuss and understand how to manage with access to the numerous company resources in place to assist with stress management. Finally, the pilot confirmed the need for an on-site component of the company’s wellness program. Feedback, participation and results indicated that having offerings accessible and visible at the worksite is valued by employees and has led to a variety of on-site challenges and activities at Boston Scientific’s U.S. locations since the conclusion of the pilot.
Boston Scientific rolled out Phase 2 of the pilot in 2014 with similar success. The company has seen improvements in its health metrics nationwide, which it at least partially attributes to increases in wellness program offerings and utilization as part of the pilot initiative. Continual improvements have been made to the available programs, and plans are now in place to roll out a network of Wellness Champions at Boston Scientific worksites across the United States.
Humana’s Well-Being: Measuring, Motivating and
Over the course of 54 years, Humana has transformed the ways it brings help and care to the people it serves. As a leader in the healthcare industry, Humana has evolved from a company with the episodic customer relationships of a traditional health insurer to a company dedicated to helping people improve their health and well-being, which has become part of the company’s culture. That shared enterprise purpose came into even sharper focus last spring when Humana publically announced a goal to improve the health of the communities it serves 20 percent by 2020, by making it easy for people to achieve their best health.
Humana took the goal a step further for its internal associate community: achieve the results by the end of 2017. Humana believes that, by changing the lives of associates, the company is more able and inspired to help others do the same. Early results are promising. Since 2012, the associate community has reversed the trend toward declining health seen elsewhere in the nation1 and has seen substantial improvements in all dimensions of well-being.
The American Heart Association CEO Roundtable
While many employers offer workplace health programs, few have the data they need to know what works best, and the know-how to implement best practices. That’s why more than 20 CEOs from some of America’s largest companies have joined the American Heart Association (AHA) to create the AHA CEO Roundtable, dedicated to disseminating evidence-based approaches to workplace health. Guided by the scientific expertise of the AHA, these CEOs are collectively engaging nearly seven million employees and family members, along with countless other community members, to transform the culture of health in America’s workplaces and beyond.
A successful business is based on more than financial
reports. It’s about the people. If leadership creates an
environment where health is a priority
…it’s a winning formula for everyone
Nancy Brown, CEO, American Heart Association