Category: Corporate Wellness

A recent article published on Slate, an online magazine of news, politics, technology, and culture, called workplace wellness programs a “sham”.  The article went on to describe how these programs, defined largely by biometric screenings and health risk assessments (HRAs), are really just cost shifting mechanisms from employers to employees.  As we read the article, we found ourselves agreeing with most of the individual points made in the entire piece yet disagreeing with the overall thesis.  For all wellness programs to be shams, these programs, as defined within the article, must be solely defined by biometric screenings, HRAs, and a number of other selectively bad services.  That being said, it is imprudent to throw the good out with the bad and characterize all wellness programs as a sham.  At the very end of the piece, the author offers hope:

“To make their employees healthier, it’s clear, employers need to totally redefine what a wellness program is.  A wellness program that’s actually about wellness would be entirely voluntary, not financially coercive.  It wouldn’t collect any personal health information from employees.  It wouldn’t weigh people or take their blood samples.  It would be truly a benefit, not a cost-saving measure.  It might reimburse employees for their gym or yoga studio memberships.  It might subsidize a community-supported agriculture membership.”

The problem with the author’s call to action is that it assumes that programs like these do not exist and that all wellness vendors promote “sham” services.  For years, Wellable has been fighting against screenings, HRAs, and excess testing.  It would have been easy for us to add these services to our solution; instead, we wrote countless blog posts and a free eBook about the myths of biometric screenings.  Furthermore, all of our programs are voluntary and do not collect personal health information.  We don’t mention this with shameless self-promotion or as if Wellable is the only company with this approach.  We find that more and more employers, brokers, and health plans are moving away from wellness as a sham to wellness as a benefit, and although the change is slower than many would like, there is a noticeable shift in how groups think about employee wellness.

5 Ugly Truths About Biometric Screenings

 
If the author (or the many people she quoted in the article) genuinely want to see a change in the employee wellness, they may best be served by identifying the specific programs that are dragging the industry to a point beyond redemption and promoting those programs that satisfy the criteria that they feel is gold standard.


Category: Facts and Research

According to a new report from IDC, market share in wearable device shipments for Q2 2016 saw fairly significant shifts relative to previous quarters.  Most notably, the Apple Watch saw its number of shipments drop more than 50% year-over-year.  Garmin also continues their strong growth, effectively grabbing the number three spot in the rankings.  Total shipment volume for the quarter came to 22.5 million units, up 26.1% from the 17.8 million units shipped in Q2 2015.  The table below breaks down the details of the shipments and ranks the leaders by market share.

q2-2016-market-share
The data provides a number of insights into the corporate wellness market so we thought we would talk about some of them below.

Fitbit Remains At The Top
Fitbit ended the quarter the same way it began it: as the undisputed worldwide leader of wearable devices.  In Q2 2016, the global leader was able to hold their top ranking with market share in line with Q2 2015 (~25%).  The latest Charge 2 and Flex 2 devices indicate that the company is maturing by giving form and function equal importance.  Fitbit’s recent acquisition of the wearable payment assets of Coin also indicate the company is looking to expand features that will help improve retention.

Xiaomi Continues To Focus In Asia And On Cost
Xiaomi delivered approximately the same number of units year-over-year (3.1 million), resulting in a small drop in market share from 17.2% in Q2 2015 to 14.0% in Q2 2016.  Despite this drop, Apple’s significant drop in units allowed Xiaomi to move to the second spot in the rankings.  The Xiaomi Mi Bands remain extremely popular in China, and in every technology market, Xiaomi continues to focus on the value conscious consumers.  The challenge for Xiaomi, however, is growing beyond China’s borders and onto the global stage.

Apple
As the only one of the market leaders to see a drop in units shipped (and a big one), Apple likely suffered from not having launched a new device since it debuted the Apple Watch.  The good news for the company is that it launched the new Apple Watch at their event last week.

Garmin = Growth
By quadrupling the growth of the entire market, Garmin is becoming a force to be reckoned with, especially in the Americas and Europe.  It continues to launch a number of devices for all types of users, which should bode well for their shipment growth.

BYOD For Wellness
The rise of numerous devices with no single brand comprising the majority of the market share creates a challenge for employers.  This challenge is why Wellable encourages the implementation of a bring your own device (BYOD) strategy for wellness.  A BYOD strategy for wellness allows employers to embrace all forms of wellness technologies, including devices and apps that are not Fitbit, Apple Watch, or Xiaomi.  It will enable consumer choice and result in lower costs for your program.  Download our free white paper for more information on BYOD for wellness.


Category: Regulatory

Earlier this year, the U.S. Food and Drug Administration (FDA) published final guidance articulating the difference between the “low-risk” digital health apps, devices for general health management, and those apps and devices that needed FDA 510(k) clearance.  In short, the FDA provided information on the kinds of apps and devices for which it will and will not take action.  Apps that assist in promoting or maintaining a healthy weight or with weight loss goals and healthy eating are not going to be subject to FDA approval.  However, apps that claim it will treat or diagnose obesity, an eating disorder, such as bulimia or anorexia, or an anxiety disorder will be subject to FDA scrutiny.  Since the FDA does not have the resources to screen the tens of thousands of digital health apps that are available in the market, the strategy to separate “low-risk” tools had to be done.

The FDA decision did not help employers that want to embrace digital health tools but also do not have the resources to identify appropriate technologies for their employees.  The good news is that Apple established rules for digital health companies aspiring to use the technology giant’s iOS network.  Below are some of the changes:

  • Apple will now have the ability to reject apps that have the potential to cause any physical harm.
  • Medication calculation or dosage apps must be developed by a drug manufacturer, hospital, university, health insurance company, or other approved entity, which means individuals cannot publish an app to manage medication dosage to the app store.
  • No more marijuana-related apps.
  • Apps that encourage people to place their iPhones under a mattress or pillow while charging (such as those that monitor sleep) will no longer be allowed.
  • If an app provides inaccurate data or information that could be used to diagnose or treat patients, it will get increased scrutiny.

With Apple’s iOS screening process having influence on the digital health community, their commitment to high quality digital health apps will be a boon for consumers globally, and as a result, employers will also be beneficiaries.  Employees will have less access to low quality and/or dangerous health technologies, and many of these app developers will likely have to shut their doors or improve their quality.  This will create more opportunities for higher quality tools and provide those companies with more resources to invest in their solutions.


Category: Corporate Wellness

Whether you are trying to build a case for financial wellness at your organization or assessing the need for it, a new survey from GoBankingRates will help you cover the top causes of stress in your area.  The statistics below focus on the aggregate results from 7,000 respondents from all 50 states plus Washington, D.C., but the link above provides specific information for each state so employers can see if their population differs from the entire group.  Below are the top seven cause of financial stress based on responses from the survey.

  • Paying off debt (cited by 20.6% of respondents)
  • Not being able to retire (15.6%)
  • Not having enough money to survive an emergency (15.6%)
  • Wanting a nicer lifestyle (14.0%)
  • Paying for education (13.1%)
  • Lack of stable income (11.7), and
  • Paying mortgage or rent (9.4%)

It is important to note that paying off debt was cited as the top source of financial stress in 32 states and was tied for first in Rhode Island (tied with lack of stable income), Maine (tied with not being able to retire), and New Hampshire (tied with not having enough money to survive an emergency).  This should be a key indicator of what financial wellness programs should focus on.

Given that a 2016 PwC survey found that more than a quarter (28%) of employees said financial issues are a distraction at work (a 20% increase from PwC’s 2015 findings), employers should be proactively addressing the financial health of their employees through benefits (e.g., 401 (k) plans) and education (e.g., seminars).

Budgeting concerns should not be a reason for employers to sit idly waiting as the problem gets worse.  For those employers with a 401 (k) plan, the plan administrator should have free financial wellness resources for their clients to use.  There are also a number of advocacy groups and wellness vendors, including Wellable, that offer a free financial wellness seminar/webinar.


Category: Mobile Wellness

Fitbit continues to expand their product line by announcing new versions of the Fitbit Flex and Fitbit Charge devices.  Since the Flex has been a staple of corporate wellness programs since it was released in 2013, the update maybe seen as long overdue for that device.  Below are brief highlights for each device.

Flex 2
According to a Fitbit blog post about the new device, the Fitbit Flex 2 is a “swim-proof” fitness wristband with a removable tracker that can track activity, exercise, and sleep.  The first ever “swim-proof” device removes any concern about getting it wet, which means it can track swimming.  The tracker is also 30% smaller than the original Flex and designed to be incorporated into more fashion-forward form factors, such as bands, bracelets, or pendants.  For example, Fitbit is selling stainless bangles that come in gold, rose gold, and silver that can discreetly hold the tracker.  With fashion concerns being an alleged cause of device adherence, the Flex 2 attacks the challenge head on.

Charge 2
The Fitbit Charge 2 will track activity, heart rate, and sleep.  The sleep features include the ability to create a sleep schedule, complete with bedtime reminders and a silent vibrating alarm for gentle wake ups.  Similar to other devices, the Charge 2 also includes reminders to get active.  The display is four times larger than the device’s predecessor, the Charge HR.  It also allows users to receive notifications from their smartphone.  According to Fitbit, the Charge HR revolutionized the industry by bringing automatic heart rate tracking to the wrist, and now Charge 2 will take that technology to the next level with an “enhanced exercise experience and new health and fitness tools…, including Cardio Fitness Level and Relax.”  Cardio Fitness Level is an estimate VO2 max that calculated based on a user’s profile, heart rate, and exercise data.  Relax is a guided mindfulness feature that creates a personalized breathing experience to calm the body and mind.  The Charge 2 also includes Connected GPS, which allows the device to use the GPS in a paired smartphone to enhance tracking statistics.

Fitbit Adventures
Fitbit also announced a new app feature call Adventures, which is a series of personal, non-competitive immersive Challenges that encourage daily activity by virtually exploring scenic and iconic destinations.  Users can virtually explore a location, starting with three routes in Yosemite National Park, unlocking new landmarks as they take more steps.  The scenes are panoramic, which allows the user to “look around” by moving their phone.


Category: Engagement

Employers should build their corporate wellness programs around the consumer wellness technology market, and Fitbit’s new Fitbit Local program is just another reason why.  In addition to producing quality hardware and software, Fitbit launches value-added programs and services to improve engagement in its programs.  For example, Fitbit acquired FitStar to go beyond data tracking and into behavior change and outcomes.

Fitbit Local has the same spirit in mind.  According the Fitbit Local website, the program helps Fitbit users “find [their] fit and stay motivated to reach [their] goals by sweating it out at local workouts led by the most talented trainers in [their] community.”  Essentially, Fitbit is trying to strengthen engagement and their brand through community building and offering free fitness classes.  In Wellable’s home city, Boston, Fitbit has local ambassadors lead free boot camps, 5K walks, and more.  One event in Boston had over 600 people!  Fitbit Local is live in 8 cities in the United States with more coming online every month.  By going beyond technology and launching physical events, Fitbit is trying to build a culture of health in communities across the world.  As employers try to build cultures of health within their organizations, they would be wise to leverage the efforts of consumer-oriented companies trying to do the same thing in their community.

Consumer Wellness Strategy
All this is good news for consumers and organizers of employer and community wellness programs.  Like consumers, organized wellness programs will be the beneficiaries of activity trackers looking to go beyond data collection.  The best way for wellness programs to capture this value is to leverage the consumer wellness market in their programming.  That is, by allowing wellness program participants to utilize one of the many consumer wellness technologies that are working hard to produce meaningful engagement tools and outcomes, wellness coordinators will be able to deliver better results, improve adherence, and lower costs.


Category: Engagement

A recent article in the Harvard Business Review explores whether too much employee engagement could be a bad thing.  The benefits of employee engagement are well documented, including being associated with higher employee wellbeing, performance, and retention.  Well-engaged business units also outperform less engaged ones in almost every metric, such as revenues, profits, service quality, and customer ratings.  Despite all these benefits, high engagement does not always translate into business performance.  Below is a quick summary of the pitfalls of high engagement.

  • Status Quo – An engaged workforce can begin to love the way things are to the point that they quit becoming self-critical, resulting in complacency and a lack of innovation. “Progress is generally driven by people who reject the status quo and are dissatisfied enough to seek to change it.”
  • Employee Burnout – “When encouraged, it’s easy for highly engaged employees to become so involved in their job that they stop being concerned about other important parts of their lives.” Burnout leads to poor job performance and declining health.
  • Benefits Certain Personality Types – Engaged employees tend to be more optimistic, emotionally stable, agreeable, and extraverted. These types of individuals thrive in highly engaged workplaces and also tend to hire similar individuals.  As a result, highly engaged workplaces can become homogenous, and diverse thinking, especially form individuals who may be less agreeable, promotes innovation.
  • Undermines Negative Thinking – Engaged employees tend to think positively, and as a result, mitigate the positive impact that pessimism can have on performance. Critical mindsets bring focus and attention to groups, which are important for target-driven outcomes.

The authors suggest that a more balanced perspective on employee engagement can go a long way.  It is also important to think about how employers engage their workforce.  Engaging employees in work-life balance programs or other wellness initiatives can help alleviate some of the burdens listed above, such as employee burnout.  Also, team-based wellness challenges can disrupt strongly affiliated groups or departments causing “disagreeableness” to increase.


Category: Wellness

All packaged food comes with a label that provides the nutritional value of that particular food so consumers know exactly what they are eating and how much of each nutrient is in that particular food.  The labels also provide the ability to compare and contrast different food ingredients and nutrients for choosing the healthiest option.  Unfortunately, individuals do not always use this wonderful tool to choose what they put in their bodies.  One reason for this is that current labels are difficult to read and interpret.

When first looking at a food label, it can be confusing where to start and what is important to look for.  Also, nutritional science is ever changing and the current food label was over 20 years old, making it long overdue for an update.  The Food and Drug Administration (FDA) took this into account, and on May 20, 2016, the FDA announced its new and improved Nutrition Facts Label for packaged foods designed to reflect new scientific information which includes the link between diet and chronic disease, such as obesity and heart disease.  Below is a summary of some of the changes.

Bigger Font So The Eyes Can See
When evaluating a label, consumers should always start at the top with serving size and then work their way down to the number of calories PER SERVING.  A huge mistake when looking at labels and deciding how much to eat occurs when individual confuse the number of calories per serving as the caloric content for the entire package.  The FDA has addressed this common error by increasing the type size and bolding the following to outline its importance: calories, servings per container, and serving size.  This will make these important aspects of the label easier to see and become a focal point of the nutritional label.

Refreshed Design Based On Science
Manufacturers are now required to show the actual amount, in addition to percent daily value of vitamin D, calcium, iron, and potassium, all of which are important nutrients in a healthy diet.  Manufacturers can voluntarily declare the gram amount for other vitamins and minerals.

Percent daily value is also better explained on the label for consumers to understand how much of the particular nutrient is relevant to their caloric needs.  It now reads the following; “The % Daily Value tells you how much a nutrient in a serving of food contributes to a daily diet.  2,000 calories a day is used for general nutrition advice.”  What a lot of consumers don’t understand is that not everyone needs 2,000 calories a day so that needs to be taken into account when looking at the percent daily value of certain nutrients.

Daily values for nutrients are also being updated to reflect new scientific evidence from the Institute of Medicine and the 2015 Dietary Guidelines Advisory Committee, which was used in developing the 2015-2020 Dietary Guidelines for Americans.

Added Sugar…Not Hidden Anymore!
Scientific data shows that it is difficult to meet nutritional needs while staying within calorie limits if you consume more than 10% of your total daily calories from added sugar.  This is consistent with the 2015-2020 Dietary Guidelines for Americans.  It is unfortunate that there are a lot of products out there that contain high amounts of added sugars to enhance the flavors of the product.  The new FDA label will indicate not only how much total sugar there is in the product but also how much of it is from added sugar measured in grams and percent daily value.

Serving Size Updated For Current Consumption
Unfortunately, people increasingly overconsuming food.  The amount of change compared to when the latest food label came out back in 1993 has changed considerably.   By law, serving size must be labeled based on what people are actually eating, not what they should eat.  This is also effected by the size of the package of food.  Some foods may be two servings but can easily be eaten in one sitting.  For packages that are between one and two servings, such as 20 ounces of soda, the calories and other nutrients will be required to be labeled as one serving because people will typically consume this in one sitting.  Hopefully, this update to the label will make consumers think twice about consuming a bottle of soda in one sitting (or in general)!

Dual Labels
Dual columns that have the number of calories and nutrients in both a single serving and a per package basis are required for certain products that are larger than a single serving but that could be consumed in one sitting or multiple sittings as well.  An example is a 24-ounce bottle of soda or a pint of ice cream.  This way people know exactly what they’re getting into before they sit in front of the TV with a pint of ice cream and a soda.  You can see the comparison here in this graphic from the FDA.

Although the nutrition labels have definitely improved, everyone will have to wait another year before seeing them on the shelves.  These new and improved labels will need to be produced by manufacturers by July 26, 2018.


Category: Facts and Research

For decades, policy analysts in developed countries have been trying to determine why waistlines in their country continue to grow.  In the United Kingdom, many believe that physical inactivity, not unhealthy diets, are the primary culprit.  According to the Living Costs and Food Survey (LCFS), a long-running study that tracks shopping in the United Kingdom, average daily calorie purchases fell from 2,534 in 1974 to 2,192 in 2013.  Another official survey based on reported food consumption found a similar pattern.  These surveys led to the widely held belief that sloth, not gluttony, is the reason for obesity in the country.

A report from the Behavioural Insights Team, a research group spun out of government, rejects this idea.  The researchers compared LCFS data with those from other sources: a private survey and measures of actual calorie consumption.  The comparison suggests that the participants in the LCFS are dramatically under-reporting their intakes.  The authors estimate that England consumes 30% to 50% more calories than declared in the LCFS.  The researchers also argue that if the daily calorie purchases did actually decrease in the last 40 years, it would need to have been akin to every adult jogging for 56 minutes less per day than in the 1970s, which is unlikely.

There are two reasons why people may have underreported their calorie consumption.  The first rationale is that this data is difficult to track, especially with snacking and eating out becoming more common.  The second rationale is that people who say they want to lose weight are more likely to underestimate how much they eat, and since overweight people are more likely to say they want to lose weight, the rise of obesity has led to a growing tendency to underreport.

This should lead one to think about self-reported data in the context of wellness programs.  Specifically, health risk assessments (HRAs) still remain popular with employer groups and health plans as a way to measure risk within a population and provide feedback to the respondent of the questionnaire.  One of the many problems with HRAs is that it relies heavily on self-reported data, and since HRAs rely on this data to provide actionable intelligence, they are victims to the limitations of self-reporting.  Similar to the LCFS challenges, many questions ask for information that respondents may not know because they are difficult to track.  Also, respondents may have a tendency to misreport.  For example, HRAs are victims of the Hawthorne effect, which is a type of reactivity in which individuals alter their behavior (most often in the direction they suspect the observers want them to) because they know they are being observed.  In the case of HRAs, employees respond to questions knowing that they are being measured on their health and want to reflect a more positive health status.  This also appears in HRAs where populations gradually improve their health over time (from HRA to HRA) because they are trying to show that their health is improving.

The study in the United Kingdom is not surprising but is interesting for those individuals in the wellness profession.  It is a reminder of the challenges employers still live with today based on practices of the past.  Employers should keep this in mind when making decisions based on results from their HRAs.


Category: Corporate Wellness

Last week, we blogged about vendors that employers should include at their company health fairs.  The vendors listed in the post cost money so for the budget-constrained organizations, this post is focused on free vendors that employers can bring to their health fairs.  One of the greatest things about health fairs is that you can get a lot of vendors willing to donate their time for a good cause – your health!  We’ve done a lot of health fairs, both participating and planning, and these are some of the free vendors that we thought were most valuable in a health fair.

Department of Public Health
Contacting your local department of public health to participate in your health fair will allow your employees to be educated on ways to stay healthy within the community.  Most departments are willing to donate their time for free or in exchange for your company participating in planned community service, which is another great team building activity.  Some departments also have separate branches specifically for healthy living in the community so be sure to do your research on their website.  Some great ideas on how to incorporate your local department of public health include:

  • Safe bike paths in the community with maps
  • Gardening techniques so employees can learn to grow their own food
  • Ways to stay active in the community
  • ealthy eating in the community
  • Ergonomics

Health Insurance Provider
Many companies offer health insurance to their employees so why not provide education on how employees can best use these services.  It is unfortunate that a lot of employees aren’t aware of many of the benefits they get with their health insurance.  Having representatives from your health plan to educate employees about their benefits can not only be advantageous to them but also save your company money on costly premiums.  Be sure your healthcare providers educate your employees about the following:

  • Health benefits based on your insurance offerings
  • Perks for exercise
  • Perks for eating healthy
  • Reimbursements for healthy living
  • Reimbursements for gym memberships
  • Coverage/Reimbursement for self-care (e.g., stress relief, fitness classes, nutrition programs, massage/acupuncture, etc.)

Gyms Or Fitness Clubs
Your local gym is a great way to get your employees active and healthy!  Most local gyms are happy to host a table and talk to your employees about membership options as well as fitness tips.  Make sure to check with your healthcare provider to see if there are any reimbursement options for memberships.  There are also many corporate options at many gyms so speaking with a membership representative prior to your health fair may be beneficial.  Your local gym can also do a multitude of other activities that can be very interactive for your employees and increase participation. These include:

  • Fitness challenges
  • Screenings (e.g., blood pressure)
  • Safe workout ideas/demo
  • Exercise demonstration
  • Exercise classes

Health Food Stores
Think Whole Foods or any other local healthy store.  These venues are usually happy to host a table and share their healthy eating tips!  Be sure to be vocal about any allergies that your employees may have so everyone is safe and can benefit from a food tasting.  Also, ask your vendors to provide recipe cards so your employees can enjoy these healthy foods at home.  You may want to focus on foods that your employees can bring to work with them or make at work since that can be a big struggle.  Some great ideas for tastings include:

  • Smoothies
  • Healthy snacks
  • Easy breakfast ideas
  • Quick lunches
  • Portable meals and snacks

Fire/Police Department
Employee safety is very important.  Utilizing the services of your local police or fire department can be very beneficial when it comes to safety in and out of the office.  These officials can educate employees on public safety, fire safety, and even rules of the road.  The following are some ideas that can be used toward the health and safety of your employees:

  • Latest information on office safety
  • Fire safety
  • CPR/AED locations and trainings
  • Road safety
  • Disaster relief and planning

How To Guide For Health Fairs
Having a health fair can be extremely beneficial for employees and does not need to cost too much.  Leveraging free vendors and existing resources can create a great base to grow from.  You may even want to check with your insurance broker or health plan.  They may offer free credits to use to purchase a few vendors to augment the free ones you invite.