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The Challenge

The Challenge. http://bigpicture.typepad.com/comments/2008/01/odd-chart-of-th.html. vanDongen JM, Proper KI, A systematic review of the the cost-effectiveness of worksite physical activity and/or nutrition programs , Scan J Environmental Health - online first.

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The Challenge

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  1. The Challenge http://bigpicture.typepad.com/comments/2008/01/odd-chart-of-th.html

  2. vanDongen JM, Proper KI, A systematic review of the the cost-effectiveness of worksite physical activity and/or nutrition programs, Scan J Environmental Health - online first. • Literature search up through January 2011 • 19 Item check list • 10 Studies (18 programs, 50% with >11/19) • 6/18 “more costly and effective”, in reducing BMI, cholesterol, CV disease • Conclusions: “Therefore, conclusions about the cost-effectiveness of worksite physical activity and/or nutrition programs cannot be made”

  3. Pelletier, KR, A Review and Analysis of the Clinical and Cost-effectiveness of Studies of Comprehensive Health Promotion and Disease Management Programs at the Worksite, JOEM, Vol 53, No 11, 2011 • Objective: review of comprehensive wellness programs • Methods: review of 27 studies identified from 2008 to 2010 (added to 169 studies in a series of 7 reviews) • Results: 8/27 reported positive cost benefit • Conclusion: • 6 elements in best practices: organizational commitment, incentives, evidence based interventions, effective implementation, ongoing evaluation • characteristics of sustainability: linking to business objectives, executive support, employee input on goals/objectives, offering variety, target high-risk, incentives, program accessibility, incentives, effective communication, evaluation of effectiveness

  4. Health Survey “I have changed and seen benefits but I go back to my old ways” “can’t seem to get this in my schedule” Not Sure What To Do No Need To Change

  5. Ovbiosa-Akinbosoye OE, Long DA, Factors Associated with Long-Term Weight Loss and Weight Maintenance, JOEM, Vol 53, Number 11, November 2011 • HRA in 89K overweight/obese individuals from 2005-2010 • Wt loss and maintenance over one year • Factors: male, reduced stress, nutrition and exercise only with changes in nutrition • Conclusion: comprehensive workplace wellness programs that address weight management throughout an integrated stress management approach can be effective in addressing the obesity epidemic

  6. Fishman DN et. al., Sharps-Related Injuries in Health Care Workers: A Case-Crossover Study, American Journal of Medicine, Volume 114, June 1, 2003 • 139 with sharps related injuries • 13 different variables in case cross-over design • 5/13 variables were predictive of being stuck • Conclusion: Our findings that “distraction, anger, and rushing in- crease the risk of sharps-related injuries...” “Interventions to minimize these factors should be explored by those who wish to prevent sharps-related injuries in the health care work- place.”

  7. “Unnatural Causes” African Americans Upper Class Perceptions of Control over Destiny “Stress” Income & Education Middle Class Lower Class Latino Immigrant

  8. Leith, Baumeister, Why Do Bad Moods Increase Self-Defeating Behavior, Journal of Personality and Social Psychology, 1996, Vol. 71, No 6, 1250-1267 • 5 different studies • Study 3: 41 Student Participants • Three Moods • Good (comedy), Neutral (nature), Bad (anger role play) • Choices • Lottery A, 70% chance of winning $2 • Lottery B, 2% chance of winning $25 • If you loose, 3 minutes of nails on the chalkboard

  9. Observations Methods -1, 792 12-17 yo -Assess viewing and sexual behavior -1 year follow-up Results 90th vs 10th percentile with 2 fold increase intercourse, non-coital activity Method -IQ test to all -Random 20% with “unusual potential” Results -Random picks outperformed controls Survey for 7 ACEs, followed forward Abuse: mental / phys / sexual abuse Mother: battered / substance abuse Member: mental illness / criminal Results IHD: smoking / PA / obesity <2 Anger: 2.5 7 ACEs:8.2 risk 30 sexual partners • Collins R, Watching Sex on TV Predicts Adolescent Initiation of Sexual Behavior, Pediatrics, Sept 2004 - Present Images • Rosenthal R, Pygmalian in the Classroom: Teacher Expectation and Pupils Development, New York: Rinehart and Winston, 1968 - Expectations of Others (Beliefs Present) • Hillis S, Adverse Childhood Experiances and Sexual Risk Behaviors in Women, Family Planning Perspectives, 2001 - Past Events (Beliefs Past) • Garg N, Influence of Incidental Affect on Consumer Food Intake, Journal of Marketing, Jan 2007 - Mood (Thought driven emotion)

  10. “Sources of Stress”: GS -the most prevalent stressors are inter-personal -concerns for children and finances -stress linked to negative affect and that gets worse with age - kindling

  11. Social Fitness social fitness: a state of social well being, in which an individual is able to use his social capabilities to function in society, and meet the ordinary needs of society. • mental fitness: a state of emotional and psychological well being, in which an individual is able to use his cognitive and mental capabilities to function in society, and meet the ordinary needs of society.

  12. 217 Surveys Personal Family Community

  13. First Responder #1 Personal Family Community

  14. First Responder #2 Personal Family Community

  15. First Responder #3 Personal Family Community

  16. Education (28) Personal Family Community

  17. Yoga Instructors (19) Personal Family Community

  18. Robert Kennedy on GDP "The gross national product includes the destruction of the redwoods and the death of Lake Superior. It grows with the production of napalm and missiles with nuclear warheads.... "And if the gross national product includes all this, there is much that it does not comprehend. It does not allow for the health of our families, the quality of their education, or the joy of their play. It is indifferent to the decency of our factories and the safety of streets alike. It does not include the beauty of our poetry or the strength of our marriages, the intelligence of our public debate or the integrity of our public officials.... "The gross national product measures neither our wit nor our courage, neither our wisdom nor our learning, neither our compassion nor our devotion to country. It measures everything, in short, except that which makes life worthwhile; and it can tell us everything about America except whether we are proud to be Americans. 24

  19. Declaration of Inter-Dependence"We the People" find ourselves in very challenging times; high unemployment, rampant wars, every escalating healthcare cost with little apparent benefit as parents often bury their young, evermore marital I do's are becoming I don't, and the masses choosing to live in ways that destroy (drains) the very planet that was designed to sustain us, our Eden.While it is hard for a drop to recognize it's contribution to the flood, I resist being a drop in the tsunami that is devastating our country, our world. Too many deaths, to many wasted dreams. The grave is full ideas and solutions; seeds that were never able to take root, having been poisoned by criticism, self doubt, hatred, and other acts of foolishness, roads that truly need less travel.Our country and our world is in trouble, and our leaders, those we look to for direction and resolve, seem to be in search of selfish rather than selfless solutions. These leaders dance in a theater of agendas that appear motionless, while those they profess to represent feel unheard (or better unloved). But it is unhelpful to convict when they are spiritually unconscious, a state of sleep that I too can be found in, and I tire at aimless pointing, so I look to myself.I find it unhelpful to drink the poison of un-forgiveness expecting my transgressors to get ill, to rob myself of healing sleep doing things that help neither me nor those that I love. I'm saddened by eating in a manner that breaks me down, rather than build me up, and ashamed of leaving tasks undone that would help me, my family, and my community. I say no more. Today, I draw a line in the sand, thrust a stake in the ground, and declare Interdependence Day.  From this day forward, I constantly look for actions that I (yes I) can take, to better myself, my family, and my community. I give the energy of my attention to the good around me, away from wickedness that I am not empowered to address, and remain aware, present, and grateful for every breath that I take.I may slip, and I may fall, but with each passing day's tender mercies I begin a new. And with God's grace I pray that I take yet another step forward.  And when you see me, if you can, offer me words of encouragement.  Because a better me makes a better we, and a better us makes for a better world.Signed: “I” the PeopleGlobal Citizen

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