Discover the three major lessons of successful program implementation

An advisory group consisting of program staff and leaders from both the school district and HealthPartners convenes annually to evaluate and assess the effectiveness of the program. The group's meetings include a program overview and discussions about the number of sites involved, available program options, and population-level health indicators from the health assessment. The discussions have informed annual program planning and staffing and provide an opportunity for leaders within the school district and HealthPartners to share ideas and discuss planning for the coming year and strategy going forward.

Central to evaluation of the ChooseWell LiveWell program is the employee health assessment offered each fall. Developed by HealthPartners, the health assessment contains a cross section of scientifically validated questions and medically approved algorithms that can accurately predict a person's likelihood of developing diabetes or heart disease in the next two to three years. It includes a series of questions in several areas: personal demographics and health history, self-care, women's health, nutrition, physical activity, alcohol and tobacco, safety, and readiness to change. The health assessment is predictive of health care costs and worker productivity indicators and has been a key instrument for the documentation of the program's impact on health and costs over time.

Annual reports are generated based on health assessment information, including summary health scores. The summary health scores allow for tracking of population health over time and are used to estimate the impact of the program on cost-related outcomes, such as estimated health care cost savings over time. In general, these indicators have shown a progressive improvement in overall population health, resulting in cost savings. In year 5 of the program, HealthPartners estimated cumulative four-year (2005-2006 through 2008-2009) health care cost savings of $632 per participant (or $158 per participant per year), based on the improvements in summary health scores. Additionally, a group of 1,942 unique individuals who participated in the program for all 5 program years, from 2005 to 2010, experienced statistically significant improvements in physical activity.

Tables 25.3 and 25.4 display the descriptive characteristics, key physical activity indicators, and aggregate improvement over time among a unique cohort of 1,942 participants who participated in the first five years of the ChooseWell LiveWell program.

The ChooseWell LiveWell program could be replicated in a variety of employer settings. The wellness website enabled easy communication and access to employees across the many sites in the school district. This program feature would serve employer populations in all sectors well, including small and medium-sized employers, and especially those with offices in many different locations.

The core ChooseWell LiveWell program components - annual employee health assessment with personalized feedback, a variety of program options, incentives for participation and effective communications - have been demonstrated to be effective in other industries. Key to the success of this program was the leadership support from both major program partners as well as the focus on building and optimizing a culture of health within the organization. Future programs should consider the specifics of organizational culture and potential impacts on program implementation. The role of the wellness website, for example, may be less impactful in sectors in which computer access is limited.

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