VHA’s Success with Increasing Movement at Work

September 7th, 2012 12:17 pm ET - Ebi Awosika, MD, MPH

How can we help keep employees from becoming office potatoes? It is a fact that a person who leads a sedentary lifestyle (commonly referred to as a couch potato) is at a higher risk of health problems such as high blood pressure, heart disease, and certain cancers, but lately we have been hearing that sitting still for more than four hours a day is an independent risk factor on its own, despite regular exercise (van der Ploe, Chey, et al, 2012). So, even if you work out for the recommended 30 minutes each day, sitting behind a desk all day still puts you at risk for major health problems.
In 2008, the Veterans Health Administration’s (VHA) wellness program

, the Employee Health Promotion/Disease Prevention program (later the Employee Health Promotion/ Disease and Impairment Prevention Program), began by designing a program that focuses on healthy eating, physical activity, stress management and tobacco cessation. All of these activities were integrated into the workplace.
The early stages of the program involved:

Creating an employee wellness community focused on employees helping each other improve their health.

Training employee wellness coaches in the fundamentals of health promotion, coaching and the use of motivational interviewing to help change behavior.

Educating employees on a variety of health related topics.

To increase opportunities for employees to add physical activity to their work days, VHA took a multi-pronged approach. Funding was provided for fitness centers, bike lockers, walking tunnels, walking paths and stairwells to provide easy access to safe, popular activities. Information about how to set up walking clubs and bike clubs was provided. Fitballs and fitball chairs were used to replace regular office chairs, along with guidelines on how to use them. Walking workstations were placed in departments where several employees could share them (see photo above). These devices, essentially treadmills with desks, computers and phones attached, allow staff to walk at a slow pace (1-2 miles per hour) and work at the same time. Wellness coaches were encouraged to become peer fitness leaders for employees. The employees were provided exercise DVD’s as well as a series of illustrated exercise handouts. Exercise instruction included yoga, zumba, conditioning, and strengthening routines. Employees received accelerometers to discourage sitting still. Unlike pedometers, accelerometers measure vertical acceleration and some vibrate when the user has been still for a period of time. Some have a color component, changing colors as the user engages in more physical activity through the day.
The VA2K (a 2 kilometer fitness walk) was created as an annual event to encourage healthy, non-competitive activity for employees while benefiting homeless Veterans through donations. In its second year, 171 locations in the Department of Veterans Affairs participated in the VA2K on May 16^th, 2012 – over 23,000 employees walked and over $242,000 in goods were collected for homeless Veterans. Preliminary evaluations show that these efforts are paying off in a trimmer, healthier VHA workforce. Their tobacco cessation program has a 20% quit rate and their weight management program has an average 5 lb weight loss and 2 inch reduction in abdominal girth over 12 weeks.
The VHA recognized the need to assist facilities in the development of standardized, effective employee health promotion services. Based on the success of the program they worked with a multidisciplinary task force to develop The Employee Health Promotion and Disease Prevention Guidebook

. The aim of this guidebook is to provide health care professionals with information and references appropriate for establishing and expanding programs at individual facilities.

The National Institute for Occupational Safety and Health (NIOSH) and VHA have long-standing relationships as intra-Federal government partners, collaborators, and advocates for healthier workers. On September 18 – 21, NIOSH, the Department of Veterans Affairs and other Federal agencies will be sponsoring the Healthier Federal Workers 2012

Symposium in Washington, D.C. VHA will be leading a health coaching certificate program during the pre-conference. They will also be sharing their proven and promising practices for a healthier and safer workforce during one of the conference sessions.
We would like to hear from you. Share with us your successes in improving the health of your workforce. What are some of your challenges?
Ebi Awosika, MD, MPH
Dr. Awosika is Director of the VHA Employee Health Promotion Disease and Impairment Prevention Program