Transit Operator Health and Wellness Programs (2004)

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62 APPENDIX C Documents Submitted by Case Study Agencies ORANGE COUNTY TRANSPORTATION AUTHORITY (OCTA) WELLNESS PROGRAM OPERATING PLAN—2003 OCTA Mission is to create, coordinate, finance, and deliver an easy-to-use transportation network that keeps Orange County moving and meets the public’s need. OCTA Wellness Program Mission is to create an environment of preventative health-related activities to motivate and as- sist the employees in their efforts to maintain good health, enhance their quality of life both at home and on the job in an effort to help OCTA meet its leadership vision to the County. Organizational Chart Chief Executive Officer Internal Audit Executive Office Strategic Planning Transportation Systems Development Government Relations Transit Operations Finance & Administration Human Resources/Risk Management Health, Safety, & Environmental Section Manager Health Specialist/Wellness Administrator Safety Specialist Environmental Specialist Intern Board of Directors

63 OPERATING PLAN Healthy employees are essential to the success of the Or- ange County Transportation Authority (OCTA). Healthy and productive employees can help us to achieve a com- petitive edge and offer excellent customer service through higher productivity, fewer absences, and lower health care costs. Employees are responsible for their own health. OCTA’s Wellness Program assists the employees in attain- ing optimum levels of physical and mental well-being. OCTA’s Wellness Program provides employees with the tools and resources to assist in improving their total well- being. The Wellness Program is designed to motivate the employee to practice healthier lifestyles. The Wellness Program has a heavy emphasis on primary prevention while focusing on exercise, nutrition, weight management, tobacco use, and cardiovascular disease detection and pre- vention. It is the goal of the Wellness Program to provide innovative and cost-effective wellness programming using an integrated multi-behavioral approach. The Program strives to provide health care systems and service that are state-of-the-art and that are specifically designed to meet the needs of the employees of the OCTA. We are commit- ted to the concept of wellness in the workplace and have the flexibility and desire to work with employees with un- usual needs. Within OCTA the Wellness Program strives to create a wellness philosophy and not just offer a series of wellness services. It recognizes management’s belief in wellness in the workplace and attempts to institute an on- going plan to create an environment that is supportive of the worker’s health, wellness, and safety. The Program uses group education for workshops, sup- port groups in the forms of lunchtime brown bag work- shops, and wellness seminars such as stress management and personal safety. The current model of the Wellness Program stands alone; as such it is not linked to other em- ployee health-related functions. Evaluations of the program are conducted after incentive programs, year end for all of the topics presented for the Learn While Lunching in addi- tion to randomly evaluating an individual session. Program Goals and Objectives • Assist employees and their families in making lifestyle behavior changes to reduce health risks. 1. Promote blood pressure awareness in the month of February, in conjunction with American Heart Month. Conduct blood pressure screenings at each location and provide health education materials to borderline hypertensives and at-risk individuals on an ongoing basis. 2. Promote men’s health issues during the month of June. The educational series and promotional materi- als will focus on PSA screening, testicular cancer, and the importance of yearly health exams for all ages. 3. Promote cholesterol awareness through educational materials and screenings during the month of Sep- tember. Conduct Cholestech screening on a quarterly basis in the Fit for Life Centers. 4. Promote diabetes awareness and screening through educational materials in the month of November. 5. Offer stress management seminars to promote the link between managing your lifestyle and health. 6. Publish and distribute monthly informational news- letters emphasizing Healthy Employee of the Quarter, Shoes and Wheels, and fitness center operations. • Enhance employee’s well-being and productivity through reduction of workers’ compensation claims and expenses. 1. Inform the employee of healthy lifestyles, nutrition, and back health education during Annual Required Training (ART) and/or Student Coach Operator Training (SCOT) of the coach operators. 2. Implement and maintain the back education program a. OCTA will contract initial screening of new hires for coach operators to determine baseline low back strength. b. Backsafe/Sitting Safe—back stretching and strengthening program and education program presented in a two-hour format emphasizing the importance of stretching, stress management, and proper body mechanics. This program will be of- fered in three stages, 2001–02 all Coach Opera- tors trained during ART, 2002–03 SCOT training, 2004 SCOT training, and 2005 ART. c. Back health education—a one-hour training ses- sion designed to inform individuals of the impor- tance of exercise and nutrition to help maintain a healthy back and discuss the pros and cons re- garding back belts. All individuals desiring to wear a back belt to perform their duties within the maintenance operations must attend the program. d. Conduct workstation evaluations at all levels of operations. e. Perform fitness center screenings, equipment ori- entations, and design exercise programs. A con- tract vendor will provide the service. • Develop new and innovative strategies to reach the groups and individuals identified with health education information. 1. Conduct yearly health fairs at each company loca- tion. 2. Provide a newsletter geared specifically to OCTA Wellness Programs on a monthly basis.

64 • Alcoholism, Job Safety, and Performance • Skin Health • New Habits for Health • Is Your Home Safe for You • Aerobic Exercise • Nutrition • Blood Pressure Control • End the Smoking Affair • Cholesterol Control • Diabetes • Weight Control/Healthy Dining • Managing Stress • Colorectal Health • Testicular/Breast Self-Examination 3. Provide a newsletter/information magazine that will address a variety of health, stress, work/family life, and money strategies via the intranet. 4. Develop educational materials and brochures that will update and advertise the programs offered by Wellness. • Establish a leadership role for the OCTA Wellness Pro- gram among the company leaders, academic institu- tions, and other public and professional organizations. 1. Participate as a member in organizations that develop worksite health promotion such as Orange County Wellness Coalition, Wellness Council of America (WELCOA), and other local worksite organizations. 2. Identify opportunities to combine company products and services with health promotion projects such as ART training, Employee Recreation Association (ERA) functions, and safety training. Healthy Employee of the Quarter/Year Employees from Administration, Operations, and Mainte- nance are recognized on a quarterly basis as Healthy Em- ployee of the Quarter. The criteria for Healthy Employee of the Quarter are: WELLNESS PROGRAM ELEMENTS—PROMOTION AND AWARENESS • A major health/fitness lifestyle change such as losing weight, dietary changes, quitting smoking, and/or starting an exercise program. Wellness Information Center The Wellness Information Center provides health informa- tion in a highly visible, professional format that is main- tained on a monthly basis and placed in special, locked glass-encased display cases at each site. Monthly themes are featured using information from national health organi- zations such as the American Heart Association, American Lung Association, American Cancer Society, etc. The Wellness Information Center features recognition for the Healthy Employee of the Quarter/Year, monthly Wellness poster, event announcements, Shoes and Wheels Points bulletin. • Maintaining a healthy lifestyle that includes regular exercise and proper diet. • Motivating other employees through example or per- sonal assistance to make healthy lifestyle changes. • Participating in any of the numerous programs of- fered through OCTA Wellness. These employees are recognized by their base man- agement and Wellness with their name placed on a plaque located in the Wellness Information Center. At the end of the fiscal year, a banquet is held honoring the 12 healthy employees. From the 12 yearly recipients, the healthy employee for the year is selected for each division. These individuals are recognized with a suit- able gift and names and photos are posted on the intra- net, Wellness Information Center, and Between the Lines (company newsletter). Monthly Wellness Posters One full-color Health and Wellness poster is provided each month for each site for a period of one year. Every effort is made to follow existing national calendar events. National health organizations and professional publishers will be used as the source for all posters. The poster is located in the Wellness Information Center. Annual Health Fair Wellness Brochures An annual Health Fair is held at each OCTA site. The staff of Wellness and the Wellness Team leaders staff the fair. Displays and information will be designed to recapture the interest of employees and to provide additional motivation to become involved in a healthier lifestyle. A series of self- testing stations are provided for those employees who to date have avoided more formal Wellness testing. A series of full-color, Health and Wellness brochures, cre- ated by Krames/Staywell Communications, Hope Publica- tions, American Heart Association, etc., are displayed in the location of each Wellness Information Center. The fol- lowing is a partial list of the topics available:

65 Exercise Low Back Syndrome Risk Factors for Disease Cancer Cardiovascular Disease Smoking/Tobacco Product Cessation Sports Injury Prevention Healthy Eating Restaurant Guide Hypertension Nutrition/Menu Planning Breast/Prostate/Testicular Cancer Weight Control/Eating Disorders Consumer Awareness/ Accidents Every two years each location’s health fair is evaluated. Employees are asked to select what vendors were most fa- vorable, as well as what vendors they would like to see at future health fairs. To help ensure participation, incentives are awarded for completed and returned evaluations. EDUCATIONAL PROGRAMS A series of educational programs and services, some with unique reward systems, are provided to create motivation and to give the necessary information for those employees who wish to improve their lifestyle and reduce their risk of future disease. The majority of these programs are directed at the monthly wellness awareness campaigns. Central Wellness Library/Video Loaner Library The library is designed to be a depository of magazines, books, tapes, brochures, and other wellness-related literature. Books, monthly journals, and newsletters are available for employees to “check-out” for a limited period of time. The video library contains health and fitness videos ad- dressing: Health and Work General Wellness Nutrition and Fitness Parenting and Pregnancy Monthly Educational Series Lecture series are provided before, during, or immediately after work or an agreed upon time convenient to the major- ity of employees. Speakers from Health Organization Speakers’ Bureaus, wellness vendors, etc., will provide the majority of the hour presentations (45 minutes for contents, 15 minutes for questions and answers). Handouts will complement each presentation. One lecture per quarter will be given to coach operators, maintenance, and/or administrative employees. Lecture times will be rotated among bases in order optimize em- ployee availability. The final list of presentations is deter- mined by the summary of the Health Risk Appraisal re- sults, national monthly wellness campaigns, yearly Learn While Lunching evaluations, and employee interest. The following is a partial list of topics: Wellness/Degenerative Disease Weight Control Role of Exercise in Wellness Work–Family Balance Stress Management Coronary Artery Disease General Health and Wellness Randomly selected seminars are evaluated for program content, format, and speaker likeability. At year end, feed- back is requested on all the topics as a rating scale for the top five topics. Evaluators are asked to share personal feel- ings for what was most informative, least informative, and what was the most significant fact learned. At the time of the evaluation, time, location, and day of week is evaluated. Back Education Classes The Wellness Program offers special classes to selected coach operators and maintenance workers. The training is designed and built to show the working relationship of the muscles of the spine, abdomen, hips, and lower extremities and is conducted by Future Industrial Technologies. A video developed by OCTA is presented to show employees the proper techniques to manage both an acute and chronic low back problem and working within the Coach. An illus- trated exercise booklet and card is given to all employees attending the training. The Low Back class is mandatory for all Coach Operators and optional for Maintenance and Administrative employees. Fit for Life Fitness Centers The program is designed to promote cardiovascular fitness and to improve strength and muscle conditioning. Fit for Life Fitness Centers are incorporated as part of the pro- gram to help reduce and lower workplace injuries and medical costs by increasing employees’ fitness levels. Each base will house a fitness center. Areas designated house cardiovascular fitness equipment and strength training equipment. The equipment shall include a minimum of a treadmill and a stationary exercise bicycle, upper and lower body strength training equipment, and 4-40 pound dumbbell rack system and incline to flat bench. Each center shall be staffed by a contractor. The staff- ing focuses on informing and instructing the employees screened and approved for exercise about personal health and fitness. The programs designed for the employees tar- get health risk factors and improve fitness levels. All em- ployees are eligible to participate in the Fit for Life Pro-

66 gram. Eligible employees must complete a fitness screen- ing to obtain access to the program. Individuals with iden- tified risk factors must seek medical approval to partici- pate. The fitness center is staffed part-time. The medical approval is necessary since the “at-risk” employee may utilize the fitness center in an unsupervised environment. Shoes and Wheels Club The Shoes and Wheels incentive program is designed to promote cardiovascular fitness and to improve overall em- ployee health. The club is available to all employees. A registration form must be completed and returned in order to begin the program. The club is a point reward system for participating in physical activity. Participants record their activity session in 15-minute increments, 15 minutes minimum/day, up to 60 minutes maximum/day. Bonus points are awarded for participation in selected activities. Employees complete a monthly log, which is input into a computer database by the Wellness Administrator or Wellness Intern. One Aerobobuck is awarded for each minute of physical activity. The em- ployee may “cash-in” their Aerobobucks for selected gifts/prizes. Catalog items include but are not limited to Shoes and Wheels logo t-shirts, shorts, sweatshirts, polo shirts, fitness/health magazine subscriptions, sporting good store gift certificates, and/or heart rate monitors. TESTING AND EVALUATION Health Needs and Interest Survey Company-wide needs assessments are conducted every two years. This tool is directed at two levels: one to staff- level employees and one to the manager–supervisor level. The tools outline health concerns of interest for educa- tional materials and seminars along with times, locations, program opportunities needed, media for marketing, and demographics of responding parties, along with barriers or obstacles needed to be overcome to help assure program and event success. This information is presented on flyers to be returned to the Wellness Administrator and via the intranet. The manager–supervisor level of assessment ad- dresses strategies for healthy work environment and health education programs. This information helps the Wellness Team approach programming from a direction that would work for both the employees and their supervisors. This sur- vey is distributed by a global e-mail addressed directly to the manager/supervisor followed with a mailed hard copy. Annual Wellness Evaluation Minimal non-invasive testing is designed to determine in- dividual and group lifestyle profiles, identify risk factors for future degenerative diseases, identify negative health behaviors, determine any employees who are high risk or who have specific risks, determine the need for addi- tional wellness testing, and identify any current physio- logical measurements or medical symptoms that may require a physician referral. Feedback will include indi- vidual reports explaining how to reduce risk factors and individual counseling for employees at high risk or with symptoms requiring medical referral and a follow-up system for employees recommended for physician refer- ral. The scope shall be limited primarily to those tests that are directly associated with measuring Health and Wellness and not disease. The screening will be initiated by the employee. Additional data are evaluated every two years. Indi- viduals with authority to operate a bus are required to re- ceive a health assessment from a qualified medical pro- vider. OCTA contracts a clinic to ascertain all information. The records are accessed and confidentiality is maintained. The data are recorded for height, weight, blood pressure, diabetes, age, and gender. Data will be compared to deter- mine the status of the health and wellness of the employees and the change in percentage of the demographics over a two-year period. This evaluation encompasses 70% of the worker population. After collection by the medical pro- vider, the data are charted and evaluated by the Wellness Administrator and Wellness Intern. Height/Weight Measurements of height and weight can be used as an indi- cator of excess weight when validated by anthropometric observation. Chart Your Progress (CYP) is a program where circumference measurements are taken to help individuals chart progress with weight loss and exercise programs. These measurements are taken at the time of evaluation when joining the Fit for Life Fitness Center. Employees participating in the center may elect to have their progress documented. Documentation is stored with the employees’ Fit for Life packet. Employees wanting to participate in the Chart Your Progress program that do not wish to be part of the fitness center may have their measurements taken by the Wellness Administrator or Wellness Intern. Such documents will be housed within Wellness. Resting Heart Rate/Resting Blood Pressure Resting heart rate can give a general indication of cardio- vascular status regarding state of health and wellness. Blood pressure screenings are available in the office of the Wellness Administrator by appointment and at each of the bases. The screenings are conducted by the contract fitness

67 center personnel during their hours of operation. Addi- tional blood pressure screening opportunities are provided as a result of Learn While Lunching presentations or during specific incentive programs. Low Back Health Screen A series of tests will be given to identify any employees with current low back problems or who might be at risk for future problems. This program will be initiated in fiscal 2000. A contract firm will conduct the tests. Tests will be performed on each new hire to establish a baseline of low back strength. Because these measurements also involve most of the major joints in the body, the test will also serve as a gen- eral indicator of overall musculoskeletal readiness. Any employee with a significant musculoskeletal deficiency would be identified and referred for additional muscu- loskeletal testing. Low back strength testing is usually not recommended as a screening procedure by most physiolo- gists due to the potential risk for injury in an asymptomatic population. Additional exercise sessions will be established to help strengthen the lower back musculature. The exer- cise sessions are conducted by the Fit for Life Fitness Cen- ter contractors. Cholesterol Screening There is no really effective way to select which employees are at risk for elevated lipoproteins since 80% of the body’s cholesterol is manufactured by the liver (endoge- nous) and only 20% is the result of dietary intake (endoge- nous). Therefore, the total serum cholesterol should be measured on all employees as a screening program for ab- normal lipids. The American Heart Association is now rec- ommending that all adults over the age of 20 be tested for their serum cholesterol level as part of a regular evaluation for risk factors. The Cholestech system will be used to measure choles- terol levels. The procedure will provide Total Choles- terol, HDL levels, HDL/LDL ratio, and has been pro- grammed to provide risk factor of developing cardiovascular disease based on the Framingham study. The testing is administered by the Fit for Life Fitness Center contractors or the Wellness Administrator. Pro- motional cholesterol testing drives will be held at a mini- mum quarterly. Data collected by the staff will be reported to the employee and tracked in an aggregated form to rec- ognize and respect privacy. High-Risk Employee Counseling Employees who are identified as high risk during the an- nual wellness evaluation or through some other structured health test will be considered eligible for counseling. The Wellness Administrator or fitness center contract staff will provide counseling, service, or program. These consulta- tions usually end with specific action items for the em- ployee to follow and maintain. Referrals to the Employee Assistance Program or the medical community will be provided if appropriate. Data collected by the staff will be reported to the employee and tracked in an aggregated form to recognize and respect privacy. Monthly Blood Pressure Screening Each fitness center will have a B/P Recording Book where all values are kept along with other information that might impact the level of blood pressure (age, weight, salt intake, stress levels, etc.). One day a month, blood pressure screenings will be conducted at each site. These records will be reviewed once/month by the Wellness Administra- tor. Data collected by the staff will be reported to the em- ployee and tracked in an aggregated form to recognize and respect privacy. Workstation Evaluation The corporate and personal workspace where an employee spends the majority of the day can influence attitude and overall work performance. This questionnaire evaluates the corporate work area, personal workspace, and the corpo- rate environment. Symptomatic employees or high-risk employees will be evaluated at their workplace for mechanical misalignment. Recommendations for improving their workplace will be provided, as well as exercises to relax tense muscle groups, exercises to relieve eyestrain, and referrals for vision test- ing if required. The need to provide an NT program that would cue employees when it is time to “take a vision break” or to perform vision exercises will be reviewed. High-Risk Hearing Testing Employees who are in high-risk areas at work for auditory abuse should have a screening audiogram. Employees will be given a specific questionnaire to determine if they fall in a high-risk category. This service will be provided on- site for all such employees. An OCTA Safety Specialist will oversee the contract service associated with audiomet- ric screening.

68 OCTA WELLNESS: Employee Needs Assessment Survey 2000 1. Which of the following health concerns would you like to know more about? (Circle all that apply.) a.) Nutrition b.) Physical activity and exercise c.) Blood pressure d.) Blood cholesterol e.) Stress management f.) Weight management g.) Tobacco h.) Heart attacks/strokes i.) Smoking 2. From which of the following sources do you currently get most of your health information? (Circle up to 3 sources.) a.) Television, radio b.) Newspapers, magazines c.) Reference books d.) Doctors e.) Other health professionals f.) Voluntary health organizations g.) Health programs sponsored by work h.) Friends, family, and other sources i.) Internet 3. There are many ways to get health information at the worksite. Which of the following ways would you prefer? (Circle all that apply.) a.) Pamphlets and other written materials b.) Films and videos c.) Talks by experts (seminars) d.) Discussion groups e.) Classes f.) Screenings/health fairs g.) Incentive programs h.) Employee assistance programs i.) Intranet j.) Newsletters 4. How long should a health promotion activity last? (Circle only one answer.) a.) Less than 30 minutes b.) 30–45 minutes c.) 45–60 minutes 5. What time of day would be best for you to participate in a health promotion activity? (Circle all that apply.) a.) In the morning before work b.) Noontime c.) Evening after work d.) Would not participate e.) Other 6. In which of the following group activities would you be likely to participate? (Check all that apply.) a.) Walking group b.) Weight control group c.) Smoking cessation group 7. Which confidential health screening tests would you have an interest and would likely participate? a.) Blood pressure b.) Blood cholesterol c.) Blood glucose d.) Colon/rectal cancer e.) Skin cancer f.) Cancers (male/female) g.) Body fat h.) Fitness assessments (cardiovascular fitness, flexibility, strength) i.) Bone density 8. Circle all the activities in which you would be likely to participate. a.) Pick up educational materials on health topics b.) Check out health/fitness video to watch at home c.) Participate in an incentive program d.) Read a health and fitness newsletter e.) Share health information with family members f.) Invite family members to participate in worksite health promotion activities g.) Help plan and promote health promotion activities at work h.) Attend a health promotion seminar or talk (single session) i.) Attend a health promotion course (multiple sessions)

69 9. Would you be willing to cost-share with OCTA for some health promotion activities? (Circle only one answer.) a.) Not interested in any health promotion activities b.) Interested, but unwilling to contribute to cost c.) Interested, and willing to contribute a reasonable amount 10. Please share some information about your work location administration BOPS maintenance. AGE RANGE 20–29 30–39 40–49 50–59 60 and older 11. Please give any suggestions or recommendations for specific activities to include. 12. Are there aspects of our work environment that should be changed to be more supportive of healthy lifesyles among our employees? If yes, please explain. 13. What kind of incentives would prompt you to make healthy behavior changes? Upon completion of the Needs Assessment, please return by March 31 to: Franet Hazard Wellness Administrator 550 South Main St. Orange

70 OCTA WELLNESS: Supervisor–Manager Needs Assessment Survey 2000 Your help is needed in planning our health promotion program. We want to be sure the program meets the needs of all of the employees and the expectations of 1. Please check all the topics that you believe should be included in an employee health promotion program. _Tobacco use _Blood pressure control _Stress management _Physical activity/exercise _Medications/drug use _Preventive exams _Eating habits and nutrition _Weight management _Warning signs and actions for heart attack and stroke 2. Please check all the strategies of activities that you would favor for an employee health promotion program. _ Educational materials–videos (shown at work and to take home) _ Talks by experts _ Health and fitness screenings, classes or courses, incentive programs _ Activities for families _ Other: 3. Please check all the strategies that you would favor to provide a supportive and healthy work environment. _Policies that support healthy lifestyles _Managers as healthy role models _Food service, vending machine programs _Activities provided free or at a low cost _Healthy newsletter generated by staff _Healthy newsletter generated by consultant _Other: ongoing evaluation of the wellness program. We want to provide you with information you need and the program's implementation and outcomes. 4. Please rank importance (1 to 5) of the following statements (1 being most important to 5 being least important). _ The company should provide a work environ- ment that is supportive of healthy lifestyles among its employees. _ The majority of health promotion programs should be available at no cost or low cost. _ Family members and employees should be encour- aged to participate in health promotion activities. _ Managers should be supportive to the health promotion activities. _ The OCTA Wellness Program should be highly visible within the company. 5. OCTA should provide funding for the health promo- tion program at a minimum level of: ___$25 per employee per year ___$50 per employee per year ___$100 per employee per year ___More than $100 per employee per year ___Other: Please tell us about your work location administration BOPS maintenance. AGE RANGE 20–29 30–39 40–49 50–59 60 and Older

71 Please list three strengths that exist within this company that will help to make the Wellness Program successful. 1. 2. 3. Please list three challenges that exist that should be considered when implementing the Wellness Program. 1. 2. 3. Please make any comments that might help us plan or improve the health promotion. Please return by March 31 to: Franet Hazard Wellness Administrator 550 S. Main St. Orange

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