Transcript Slide 1

June 18-19, 2009
Sponsored by
|
Hyatt Regency Chicago
American Cancer Society Workplace Solutions:
Using Evidence Based Strategies to Focus on Chronic
Disease Prevention among Your Workforce
Jeff Cross, MPH
Workplace Solutions Products Manager
American Cancer Society
Today’s Topics
1. Background
 Health Effects
 Trends
 Costs
2. Solutions
 Workplace Policies
 Employee Health Promotion Programs
3. How ACS Can Help
 Tobacco Cessation
 Weight Management
Cancer
Cancer is the #1 cause of death among
working-age adults in the United States.
• One-third are caused by tobacco use.
• One-third are related to overweight/obesity,
physical inactivity, and nutrition.
“Two-thirds of cancer deaths can be prevented”
--John Seffrin, CEO , American Cancer Society
Prevention
Reduce population risk for cancer and other chronic diseases
using evidence-based strategies for changing health
behaviors.
• Quitting tobacco
• Being physically active
• Eating well
• Getting screened for cancer
Cancer #1 Cost For Employers
Medical Expenditures (2005)
90,000
80,000
70,000
($ million)
60,000
50,000
Other Sources
40,000
Employer-paid
30,000
20,000
10,000
Cancer
Trauma
Heart
conditions
Births
COPD, Asthma
Why ACS?
Value
Reputation
Reach
Cause
– Mission-driven
– Non-profit cost structure drives cost-effective
program design and delivery
– 98% name recognition
– Research-centric: discovery and dissemination
– Local: 3,400 offices in the United States
– Global: operate in Asia, Africa, & the Americas
– Cancer is the leading cause of death of
working-age Americans
– Fast-growing threat to public health, globally
Mission Match
Improving health behaviors reduces cancer risk
and directly benefits employers’ bottom-line
ACS has expertise in achieving health behavior
change
Problem
Underuse of effective treatment
 80% of smokers who attempt to
quit do so without stop-smoking
medications or any other method
of assistance.
 75% of people trying to lose weight
do so without combining diet and
exercise.
Health behaviors occur in context
Context
Workplace
Practices
Health
Behaviors
Target
Outcomes
Benefits
 Tobacco use
 Health
Policies
 Physical activity
 Health care costs
Programs
 Fruits & vegetables
 Productivity
What your company does (or doesn’t do) defines the context.
Evidence-base
What is “evidence-based”?
• U.S. Task Force on Community Preventive Services
http://www.thecommunityguide.org
What is the Community Guide?
• “recommendations based on the evidence gathered
in systematic scientific reviews of published
studies…”
Workplace Health Promotion Best Practices
“TOP 15”
Five Categories
Benefits
Policies
Programs
Tracking
Communication
Four Behaviors
Tobacco cessation
Physical activity
Nutrition
Cancer screening & care
Aligning Policies
Effective policies:
1. Directly influence behavior
change
2. Facilitate use of effective
treatment for behavior change
3. Support maintenance of behavior
change
Advantages
• Low-cost
• Long-lasting
• Leverage existing benefits &
programs
• Reach entire workforce
• Goal is to align policies to
support target behaviors
Tobacco Cessation
Tobacco Use Trends
19.8% of Americans
currently use
tobacco
Tobacco use among
adults employed
Full time: 29.1%
Source: Centers for Disease
Control and Prevention,
Behavioral Risk Factor
Surveillance System
(BRFSS)
2007. Available at:
http://www.cdc.gov/brfss
Tobacco Policy Trends
Cost of Tobacco
• Treatment for
disease caused by
tobacco
• Exacerbates disease
not caused by
tobacco
• Decreases
treatment
effectiveness
Toba ccor e la t e d
15%
A ll Ot he r
Cost s
85%
The estimated difference in average annual medical expenditures between smokers and
non-smokers is $2,583 per tobacco user.
Source:
Centers for Disease Control and Prevention. MMWR — Cigarette Smoking-Attributable Morbidity — United States, 2000
September 5, 2003 / Vol. 52 / No. 35
Productivity
• Tobacco-related work productivity loss is $1,200/tobacco
user/year based on smoker versus non-smoker differences in:
• Absenteeism of 3 days/year
• At-work productivity of 10 minutes/day, attributable to excess
break time
• Total time loss of 67.5 hrs/yr is multiplied by $17.77/hour,
the current national average hourly wage.
Source:
Warner KE, et al “Health and Economic Implications of a Work-Site Smoking Cessation Program: A Simulation Analysis”
JOEM 1996; 38(10) 981-92. Data are from the National Health Interview Survey.
Halpern MT. “Impact of smoking status on workplace absenteeism and productivity” Tobacco Control 2001;10:233-38.
Bureau of Labor Statistics, Mar 2006 USDL 07-0486. http://www.bls.gov/news.release/empsit.nr0.htm
Tobacco Cessation Solutions
Ban tobacco use at worksites
•Reduces ETS exposure by 72%
•3.8% reduction in smoking prevalence
•Reduces amount smoked by 3.1 cigarettes
per day
Provide full coverage for tobacco
cessation aids
•Increases quit attempts by 7.0%
Increases # of quitters by 7.8%
Require plans to send reminders to
network providers
•Increases # patients who receive advice
to quit by 20%
•Increase # of quitters by 4.7 percentage
point.
Sponsor telephone counseling
•Increases # of quitters by 41%
Policies that Work Tobacco-free
Smoking bans prohibit smoking entirely; smoking restrictions limit smoking to designated areas.
Critical aspects of the policy:
• Must be written & posted
• Link to values and business strategy
• Indicate where smoking is prohibited
• Specify enforcement methods
• Eliminate breaks for smoking
• Provide support for smokers to quit
Effects:
• Reduces environmental tobacco smoke exposure by 72%
• Reduces prevalence of smoking by 3.8%
• Reduces amount smoked by 3.1 cigarettes per day
Source:
Fichtenberg CM, Glantz SA. Effect of smoke-free workplaces on smoking behaviour: systematic review. British Medical
Journal 2002;325(7357):188.
Policies the Work: Reminders
Provider reminder systems identify patients who use tobacco products and prompt providers to discuss
cessation with them.
Implementation: Health plans administered
Effects:
Because even brief provider advice has a demonstrated effect on
getting clients to quit, provider reminders:
– Increase # patients who receive advice to quit by 20%
– Increase # of quitters by 4.7 percentage point.
How ACS Can Help
Weight Management
Obesity Trends* Among U.S. Adults
BRFSS, 2007
*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person
No Data
<10%
10%–14%
15%–19%
20%–24%
25%–29%
≥30%
Current Trends
Risk Factor
Prevalence (%)
2005
2007
Obesity
24.4
26.3 
Overweight
36.7
36.6 
Physical Activity
(30 min/ day x 5/wk)
48.7
49.2 
Nutrition
(5 fruits & vegetables per day)
23.2
24.3 
Obesity & Mortality
• Fastest growing cause of death, globally.
• About 350,000 deaths are attributable to obesity each year.
• About 1/3 of all cancer deaths can be prevented if we eat well, are physically
active, and maintain a healthy weight.*
SOURCE:
CDC, ACS Facts & Figures
Cost of Obesity
• Excess costs for
obesity: $10K per
person
• Approximately onethird of all medical
costs for overweight
and obesity in the
United States are
paid by employers.
SOURCES:
Finkelstein, EA, Fiebelkorn, IC, Wang, G. National medical spending attributable to overweight and obesity:
How much, and who’s paying? Health Affairs 2003;W3;219–226.
Weight Management Strategies
Point-of-decision prompts
• 54% increase in stair use
Enhance access for physical activity
• 25% increase in adherence to PA
guidelines
Make healthy food choices available and
affordable
• 300% increase in fruit & salad
purchases when prices cut by half
Individualized goal-setting
• 35% increase in time being active;
Non-family social support
• 64% increase in energy expenditure
Multi-component programs for weight
management
• 5-25 pound weight loss per participant
Source:
US Task Force on Community Preventive Services. www.thecommunityguide.org
How ACS Can Help
ACS Workplace Solutions to help
your Employees Quit Tobacco
Shelley MacAllister
Tobacco Cessation Products Manager
American Cancer Society
Facts About Quitting
• Most smokers say they want to quit (70%) and, each year,
nearly half make an attempt (44%).
• Without help, less than 5% of smokers quit successfully. With
help, quit rates are 2-10x greater.
• The limiting factor is use of effective treatment.
• Availability, affordability and awareness drive utilization.
 Evidence based tobacco group support program
 Motivational intervention activities
 Education about medication and approaches to quitting
 Social support
 Industry leading program
 Proactive counseling with highly trained professionals
 Pharmacological support assistance
 Promotional guidance services
Quitline Clinical Trials
Past trials:
– Dose response trial
– Beck Depression trial
– Fax referral trial with Virginia Commonwealth
University
– Dyadic Efficacy trial
New Trials:
–
–
–
–
E-mail study
Reactive session
Depressive mood assessment
Health care provider referrals
American Cancer Society Quitline—
an Industry-Leader
• Brand
• Price
• Experience
• Support
• Results
• Reach
Quitting
• Cessation treatments
more than double a
smoker’s chances of
quitting successfully.
• Combining counseling
with medication yields
the highest quit rates.
Treatment
Quit Rate
Quitline with medication
28.1%
Varenicline
(Chantix®)
25.4%
Bupropion SR
(Zyban®)
24.2%
Nicotine Patch
23.4%
Nicotine Gum
19.0%
Quitline (counseling only)
12.7%
Self-help
8.5%
SOURCE:
Fiore MC, Jaén CR, Baker TB, et al. Treating Tobacco Use and Dependence: 2008 Update. Clinical Practice
Guideline. Rockville, MD: U.S. Department of Health and Human Services. Public Health Service. May 2008.
Account Support
• Nationwide Field Staff – We have dedicated staff
across the country to help your program succeed
• Quitline® Account Management – Located at Quitline
operations site in Austin, TX – helps with initial
launch and provides ongoing assistance
Commitment to Effective Utilization
• Initial program design is important
• Removing barriers increases utilization and satisfaction with
service
• Monthly utilization reports include how heard responses to
gauge success of promotional strategy
• We offer state-of-the-art Print on Demand service that allows
free co-branding of all promotional items
Successful Quitline programs include strong program design and
consistent promotional strategy
Sample Print On Demand
Workplace Solutions to help your
Employees Manage Weight
Heather Adams
Nutrition & Physical Activity Products Manager
American Cancer Society
Facts About Weight Loss
• 28% of the population is actively trying to maintain their
weight, 33%-40% of women are trying to lose weight and
20%-24% of men are trying to lose weight
• Concerns about future and current health, fitness, and
appearance were cited frequently by survey respondents as
the most important reasons for trying to lose weight
• Successful weight loss programs incorporate realistic goals
and lifestyle changes, behavior changes should be
comfortable for people to adhere long term
Source:
National Library of Medicine: http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=hstat4.section.24813
A Worksite tool for planning healthy meetings and events
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Quick, easy, and affordable ideas to energize business events
General tips for healthy meals and snacks
Advice on working with a facility chef or caterer
Tips on how to incorporate physical activity into meetings
 Provides completely automated program delivery
 Generates comprehensive reports
 Allows benchmarking and measurement of behavior change
 Provides commercial quality product provided to you at no cost
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Innovative, evidence based weight management program
Based on a two year research study, involving 50+ companies
Telephone based counseling service
Focused around five strategies:
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•
•
•
•
Stimulus control
Self monitoring
Cognitive restructuring
Stress management
Social support
Self-Reported Change in Weight
35.0%
30.0%
25.0%
20.0%
15.0%
10.0%
5.0%
0.0%
31.7%
26.1%
18.8%
13.1%
4.6%
5%
3 months
7.2%
10%
6 months
12 months
Participants classified as overweight or obese at baseline
ROI Potential
Obesity Prevention
• Nearly 100% weight maintenance among normal-weight participants
• Avert future increase in obesity-related costs ($10K)
Weight Loss
• 31% of overweight/obese participants maintained at least a 5% weight loss
at 12 mos. 13% reported at least a 10% weight loss.
• Returns of $2,200 to $5,300 per person
SOURCES:
National Heart, Lung, and Blood Institute. Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and
Obesity in Adults, 1998. pp. 1-228.
The Economics of Obesity A Report on the Workshop Held at USDA’s Economic Research Service
Change in Fruit/Vegetable Consumption
2.00
1.50
1.00
1.44
1.43
1.39
1.15
0.96
0.94
0.50
0.00
3 months
6 months
Counseling
Self-Help
12 months
Materials & Online Tools
For more information, please visit
www.acsworkplacesolutions.com
Sponsored by
or call us at 800-ACS-2345