life let me give you another another
anecdote lady decides to join the
cycling group of work she hasn’t been on
a bicycle in years she’s riding her
bicycle and by the way she’s type 2
diabetic in fact she maxed out on the
pills and she’s now injecting as well
over time through cycling with the group
at work and outside of work she is now
on this on one pill a day and some days
she doesn’t have to eject it all why
because she got a little bit more active
so there’s anecdotal evidence that
workplace programs work because both of
those examples are from a real workplace
from real people who made decisions
based on having workplace wellness
program in their workplace is the
workplace the place where health should
happen though well when you think about
it anybody who’s got a full-time job
probably works anywhere from seven to
ten hours a day every day at work and
then they have some sleep time so that
doesn’t leave a whole lot of other time
for health care university student
you’re probably working 14 hours a day
there’s another more compelling reason
why the workplace is the right place for
help and for health information this is
some research I was done by Shona Burke
and her colleagues and what this
suggests is that the effect size is
greater for what we call a true group
now a true group is people who interact
with each other like colleagues at work
like friends and so on and for any of
you who have ever tried to go on a diet
tried to get on an exercise regime by
yourself it is just about impossible
when you’ve got its peer support and if
that peer support is with you seven
hours a day or eight hours a day at work
then it becomes a whole lot easier and
quite clearly from from Professor
Burke’s work and colleagues we can see
that having that true group supporting
you in health makes a big difference let
me tell you about about a research
project that we started this is we
started actually way back in 2011 was
when the idea for this
project first started the idea behind it
was is that we couldn’t find evidence
for workplace wellness programs
effectiveness there was lots of
anecdotal work there was lots of kind of
pretest post-test you know we put in a
wellness program at time one and at the
end of four years we’ve got all of these
you know decrease in drug costs we’ve
got improvement in people’s health and
so on that however is not evidence from
a scientific point of view and you all
know that there’s kind of a hierarchy in
terms of evidence yeah a randomized
control trial is at the top all right
then you kind of work your way down and
way down near the middle is kind of
pretest post-test and way down at the
bottom is anecdote in terms of what we
consider to be evidence in science and
so we wanted to go in and do the best
study we possibly could in terms of
trying to find the evidence for
workplace wellness programs the best we
could do was a treatment control group
study across time we couldn’t do a
randomized control trial because quite
clearly the companies had to volunteer
to put in a wellness program and their
organizations the employees in the
treatment group they had to volunteer to
be as part a part of the Wellness
Program even the control group they had
to volunteer to be to be part of the
control group and to fill out surveys
and so on so this isn’t a randomized
control trial but this is kind of the
best that we could do and by the way
this is what a two year study looks like
it’s like six years already and we’re
probably going to be having outputs for
a few more years after that you can see
from this that it was in two phases
phase one we did a meta-analysis I’m
going to talk very briefly about that
phase two is this kind of treatment and
control group study and we’ve only just
finished that this summer and so some of
the data that I’m going to be talking to
you about now is is that recent like it
isn’t even impressed I was going to say
hot off the press but it isn’t even
gotten depressed yet right we’re just
we’re just trying to get the information
out as quickly as we possibly can
without jeopardizing our position to our
ability to publish the work at a later
date let’s talk about the meta-analysis
you already heard earlier today from
Shane about Cochrane reviews let me tell
you a meta-analysis is probably the
biggest idea in the last hundred years
meta analyses have saved more lives than
people
we’ll meet in your entire lifetime what
amount meta-analysis does is it takes a
whole bunch of different studies yeah
that read that meet a certain level of
rigor it pulls them all together as if
they were a single study and now you’ve
got much more statistical power yeah now
you can get much stronger much more
significant correlations and so that’s
what you do with the meta-analysis so we
did a meta-analysis on all of the
research that was done we started out we
want to find all the research that was
done in Canada all the credible research
with at least the treatment and control
group we found none so then we said okay
well lets relax our eligibility criteria
and let’s do treatment and comparison
group we found none lots pretest
post-test but now we’re getting too low
in the scale in terms of what would
qualify as evidence for us so then we
said okay there’s no Canadian work
there’s some really good work done in
the US but no Canadian work so let’s do
the whole rest of the world published in
English except for the u.s. because that
works already been done most notably by
baker and colleagues from harvard and
these are the results that we got you
can save 14 to thirty-six percent
absenteeism if you have a wellness
program we looked at some 504 papers you
know how many we got that were rigorous
enough we could actually use in our
meta-analysis yeah for I was so
depressed yeah I remember walking into
me I says we got four papers and one of
my colleagues is on the research team
professor Greg is eric said you know
what he’s a he’s a health economist he
said my space for is good and I said
excellent we’ll go for it so we did
before these are the results that we’ve
got you can save one point five to one
point seven days worth of absenteeism on
average if you put in a workplace
wellness program what that means for
point six billion dollars in absenteeism
alone if you put in a wellness program
now there’s another thing to be thinking
about in terms of absence when we’re
talking about absence what they’re
calculating is what we’re paying the
employee for doing no work because
they’re not here the true value of that
employee is their productive value
what’s the multiple the reason they’re
paying you 20 bucks an hour is because
you’re worth 50 so that’s the number you
should be going for ya so now do a
multiple on that 3.6 billion you can see
what absenteeism is costing the Canadian
economy every year and that’s just
absent kids never mind all the other
human costs okay so that that was the
start in absenteeism was all we could
talk about all of those studies all over
the world and the only conclusion we
could come to for which we had data was
about absenteeism nothing about reduced
drug costs nothing about improved health
etc etc so obviously there was room for
our study here’s what our study looks
like we have a treatment group and the
treatment group and the control groups
are both exactly the same company but
they’re geographically distinct so the
treatment group is in one building in
one city the control group is the same
company but in another building in
another city or maybe they’re out in the
field and the reason why we did this
because we want to control for a host of
variables we want to control for the
policy space some organizational culture
the suppliers the buyers the industry
right Ronnie belt because in the end we
want to compare the treatment group to
the control group and we want to be able
to say with some kind of certainty that
the difference we’re seeing is not a
function of things outside of the
organization but they’re a function of
the wellness program itself and that’s
important to be able to do that and
frankly that hasn’t been done before so
we actually have our control groups
divided in two we’ve got one group of
controls get the survey yeah because we
want to compare the treatment control
groups so we need to survey data the
other set of control groups has the
survey as well as biometric screening
clinics now we know that by surveying
people and especially by giving them
biometric screening clinics we are
shrinking that magnitude of effect right
between the treatment group in the
control group why because if
you do anything for your people they
will respond positively that’s called
business we call that the Hawthorne
effect right and it’s from a general
electric study where they turned up the
lights to see if employees would work
harder and they did they thought wow
this is really cool let’s go write it up
so they turned the lights down as they
left and guess what people work harder
it had nothing to do with the lights it
was the fact that you actually did
something for your people all right
that’s what makes a difference so we
know that people respond right to being
serving so just by surveying them just
by giving them biometric screening
clinics we knew we would be changing
their behaviors and by the way we
purposely change some behaviors so for
example we had people in a control group
where we had them at the biometric
screening clinic and we had to say to
them look we are not doing a diagnosis
it was a registered nurse that was
actually doing the clinic we’re not
doing a diagnosis but you know take this
piece of paper take these numbers and
please please please go see your dog so
we were already changing people’s health
behaviors well frankly that was the
other thing to do and you all would have
done the sandwich err this is what the
study looks like across Canada we had
sadly nobody from Eastern Canada but we
had all the other problems as
represented and the topography actually
represents the number of participants we
had we had six companies 28 says sites
some 840 people participate actually 104
actually signed consent forms we had a
really good selection of industries we
had a really good selection of job
categories so we had managers executives
had sales people at cetera et cetera so
this isn’t purely representative of the
of a Canadian it would if it was a
randomized control trial it would be
much more representative of Canada but
we’re pretty close we’re pretty close
we’re pretty close in terms of age we’re
pretty close in terms of body mass index
for example so it’s reasonable and we’re
pretty happy with it and a fairly
confident that our results will be
reasonably generalizable certainly in a
Canadian context
one of the things that we developed as
part of the Wellness Program is we
develop this index and on the far
right-hand side we have a whole series
of survey question items that feed into
all of these all of these sub components
now the survey questions that feed into
those sub components are all behavioral
questions not perception questions and
that’s really important and that makes a
difference because we ran the
correlations between people’s
perceptions of their health and the
numbers that we got from the biometric
screening and there’s zero correlation
zero correlation people’s perceptions of
themselves aren’t the same as themselves
I mean my perception of myself when I
look in the mirror I love to cycle yeah
so when I look in a mammal by the way
middle-aged man and like her yeah okay
so and I know you’re all picture get
your mind right um so I look in the
mirror and I see Chris Froome right the
winner of the Tour de France or rider
hey Joe doll you know the Canadian new
one the 0 to tell you a couple years ago
when you guys look at me you probably
see an old guy yeah okay so perception
is totally different from the reality
and so that’s exactly what we found with
people’s perceptions of their help now
all of these sub components feed into
these these components here and these
components are all waited from the
literature so forty-four percent is for
culture and engagement 22% for stress
and by the way when when executives are
surveyed about the most important
elements in their in their business they
talk about engagement they talk about
stress yeah so it’s no wonder that these
these know
came up the way they did and then based
on this waiting they all feed into this
organizational wellness index reason we
developed this index is so that people
could see where they stood at one point
in time with your organization what
their score was if you like report card
and then they could do it again six
months later or a year later yeah they
can see whether they’re improving or
whether they’re or whether they’re not
and be able to take remedial action so
I’m going to talk to you a little bit
about some of the results from this from
this wellness index and then I’m going
to talk about a couple of the things
that we’ve got come out of the come out
of the research so far this is what
we’ve got so far this is wellness index
stuff and if you look at the overall
wellness index yeah this is the
treatment group six point eight points
improvement this is the control group
2.7 now remember both of those control
groups are actually increased because
we’re surveying and especially for the
ones that got both the survey and the
biometric screening there’s a lot of
people change their change their
behaviors because because they got
screened but even if that wasn’t the
case this is Tony yeah let’s look at
some of these other numbers some of the
stuff we know about addiction alcohol
and tobacco for example we heard this
morning already yeah very difficult to
change those and this was a two year
study and we saw zero improvement in the
in the treatment group and a little bit
of a decrease in the in the control
group if we look at stress that’s pretty
nice we were pretty happy to see that
yeah that is they that is a significant
that’s a improvement over the control
group if you look over here culture and
engagement nutrition basically about the
same I mean everybody’s being bombarded
I mean Bacon’s not good for you know
it’s not good for you don’t drink too
much water okay so you know we’re
bombarded with nutrition so it’s no
wonder that these two are the same but
look at this increase in physical
activity I get all goosebump like when I
see that that is absolutely remarkable
one of the things that we know is the
very famous study by booth at all they
claim that the sink
most important intervention they can
think of to improve some 17 health risk
factors is exercise you’ve all heard of
sitting disease we are which is becoming
a really popular now you’re not supposed
to sit more than more than an hour
without getting up and moving around
yeah well that’s Wow look at the impact
we’re having here early indications this
is this is looking this is looking
pretty nice in terms of health and
remember you have to have a health case
and a business case I feel so sorry for
people who want to get a workplace
wellness program in their organization
whether it’s a business or a not for
profit or government department or
whatever because they got a tough road
to hoe you have to walk in and say okay
it’s going to improve people’s health
yeah and then the chief finance officer
says but will there be a return on
investment or is this going to cost
where is the evidence that it works and
how much is this going to cost us and
right now frankly as you heard earlier
there is no evidence so we’re hoping
that some of the evidence that we’re
producing here will help people as they
go into into the the boardrooms for that
critical meeting with finance officer to
say you know what known is it better for
people’s health business case to so this
is a good argument for that for the
health case and we’ve seen that there is
a good argument for the business case
just from the savings in absenteeism
alone this is a little bit small for you
to read but there’s a couple things I
want to flag up for you here number one
is the perception of a lack of healthy
food choices that’s come down by six
points lack of knowledge has come down
you can read as well as I can’t 7.8
points8 points the excuses are falling
away over two years yeah and so people
are getting more information they’re
becoming more motivated and there’s one
other really interesting finding here
that we hadn’t hadn’t expected that’s
this one it’s going the wrong way after
two years
yeah the top line is baseline the next
line is two years later and look at that
worst by six points and that’s lack of
support at home so we thought about that
for a while and we thought you know what
that actually makes sense his dad’s at
work and he’s getting some some
information about health and he comes
home and he says kids no macaroni cheese
and hotdogs tonight we have a fish in a
salad yeah you’re going to get pushed
back at home yeah when you’re starting
to change habits and so if we want
workplace wellness programs to be
successful when we implement them not
only do we have to do all of the things
that we know we need to do about any
kind of a change then get management on
board set up the processes make sure the
structures right etc etc etc but we’ve
got to make sure we help our employees
understand how to deal with their
families because what we want we really
really want it want wellness to help the
family help the employee we want to go
back and feed into their families and
into our communities if we can do that
then we’re on to something my message
today is that wellness works it’s good
for people it’s good for business it’s
good for our communities it’s good for
our health budgets it’s good for
population health it’s good for
government this is win win wellness is
an idea worth spreading [Applause]