It’s one of the ironies of the healthcare profession. The men and women who care for the sick and injured often have a very high risk of obesity, despite knowing the effects of such a condition.
The problem, explains Angie Villamaria, director of associate wellness for Centura Health, is that those professionals work long and erratic hours, are in a stressful environment and cannot find time to prepare or obtain healthy and nutritious meals.
“We don’t move as much; we have a culture where super-size is better, and I think that healthcare workers are on the same trend as the rest of the nation,” she says.
So, tasked with the wellness of her colleagues, Villamaria decided to do something about it.
The 44-year-old set up a program to help the more than 22,000 healthcare professionals and their spouses in her practice who were carrying around extra weight. Centura Health is the largest health network in Colorado and western Kansas.
“Healthcare workers face a challenge in that healthcare is delivered 24/7, so you have an added factor built into it where you have people working nights or on different sleep patterns, which I believe also affects people’s overall well-being,” she says.
The initiative started more than six years ago by first diagnosing the problem.
“In the healthcare industry, we’re primarily female and we’re caretakers. We take care of everybody else before we take care of ourselves,” Villamaria says. “Some of our challenge has been in shifting or trying to help [these workers] shift the mindset that they can’t really care for others until they care for themselves.”
It was not an entirely new project. “In my role I impact wellness and well-being, I’m not a benefits person although I fall under benefits but my real role is to look at improving health outcomes of our associate population and the spouses on the medical plan.”
For Centura Health’s well-being program, the obesity initiative was about more than counting calories. “It truly is about the mind, body and spirit of an individual. We believe that an individual’s environment plays a role in their overall health,” Villamaria says. “For example, we believe it’s important for people to have relationships, for them to have some sort of spirituality, [such as a] belief in a higher being, belief in a purpose for them as an individual.”
She adds that physical activity and nutrition play a strong role in an individual’s health — a fact that has been known for a long time and has been the focus of attention in the public health world and yet, she says, “we still have the obesity rates climbing at a crazy rate.”
To accomplish her fitness goals, Villamaria engaged the services of Retrofit, a targeted weight-loss program designed for employee benefit programs inside large-scale businesses and organizations. The Chicago-based firm has helped such clients as DeVry, Dr Pepper-Snapple Group, PSE&G and Yum Brands in their efforts to reduce the weight of workers.
Centura Health covers 17 hospitals and 54 other locations, including urgent-care centers, Flight for Life and senior-living services in Colorado and western Kansas. Centura was a perfect fit for the Retrofit program, even with its widespread locations and round-the-clock employee shifts.
“Angie knew that building awareness, creating buzz and driving interest would be critical to engaging Centura’s population in a targeted weight-management solution,” says Nora Dudley, a public relations director for Retrofit.
Seeing the results
The results were impressive: Within three months, 90% of Centura participants were losing weight. An estimated 26% had lost 5% or more of their body weight and 4% had moved out of the morbidly obese category. The total Centura Health pounds lost totaled 1,135, with an average weight loss of 3.7%.
“We started out simply, with programs, recognition awareness and challenges around nutrition and weight management, then we moved to a participation-based program where we said, ‘We’re going to give you some dollars for completing the biometric screen and the health assessment and testing to not using tobacco,’” Villamaria says.
The company is now in year three of a full-fledged outcome-based wellness incentive program. Centurareduces medical plan premiums for people who meet their targeted biometrics screening measurements, and it puts a focus on risk reduction for metabolic syndromes such as diabetes.
“I believe our program has been successful because of the focus put on overall well-being,” Villamaria says. “We have a policy in place that we started in January 2015 where we do not hire tobacco users. We have removed fryers in the nutritional services areas in most of our hospitals, and we offer wellness meals each day at a reduced cost.”
Centura Health has continued the wellness incentive program by offering a reduced medical plan premium. If members and their spouses are on the Retrofit plan, they can earn $1,000 in savings from their medical plan.
What is the Centura Health plan for the future?
Villamaria plans to look at the health of the Centura population and begin offering “programs that are specific and relevant to our associates so that we’re not doing such broad programs, but really helping individuals who are at a stage of readiness to really help them improve their overall health,” she says.
This could include, for example, partnering with different vendors on weight-management solutions, helping employees with their financial well-being and examining some of the social determinants of how that individual’s health might be affected.
“I’m thinking outside the box of your traditional physical activity and nutrition focus, but more looking at an individual holistically and really trying to provide programs and resources to them that help,” Villamaria says.
She says this will involve working closely with vendors who can manage employee data that can reveal where people are in terms of their readiness to receive help. “It’s partnering with the right individuals or building it ourselves internally, [looking at] what kinds of things we think would be valuable to our associates based on what we’ve heard and what the data tells us,” she says.
In the meantime, thanks to the success of the Retrofit implementation, Villamaria has been a vocal supporter of the benefits of the obesity initiative in both the local community employer market and the healthcare arena.
“Looking at healthcare as a leader in changing the curve on obesity rates and diabetes prevention and really looking at that prevention model and being leaders I think is something that most health care systems are looking at today,” Villamaria says.
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