INSPIRING Healthy CHANGE IN THE Worksite ENVIRONMENT 2009 NETWORK FOR A HEALTHY CALIFORNIA

1. INSPIRING Healthy CHANGE IN THE Worksite ENVIRONMENT 2009 NETWORK FOR A HEALTHY CALIFORNIA Liz A. Torres, MSW Executive Director 5955 S. Western Avenue Los Angeles, CA 90047 323.758.9480 ltorres@worksitewellnessla.org

2. OVERVIEW • Worksite Wellness LA (WWLA) • Community Need • Target Population • Recruitment of Businesses • Services • Nutrition & Physical Activity • Collaboration with LA Regional Network • Challenges • Lessons Learned

3. WWLA MODEL • WWLA’s mission is to improve the health of low income workers and their families through worksite wellness. • Founded in 1996 to bring basic health education and health access information to medically underserved and uninsured low-income workers in Central Los Angeles’ light manufacturing industries. • Work in partnership with small business owners and health care providers to deliver culturally and linguistically appropriate health promotion activities at the worksite. • Use peer health promotoras to assist in the delivery of services. • Currently work with seventeen worksites

4. COMMUNITY NEED • In surrounding areas of downtown Los Angeles, a significant number of low-wage workers employed in light manufacturing industries. • Typically do not receive health benefits or wellness programs from their employer. • As a result, they and their families are uninsured and have limited access to health care or health information. A worker attending a nutrition workshop at garment manufacturing site

5. COMMUNITY NEED • Many are unaware of when and where to seek preventive and/or routine care that can mean the difference between a minor and a major health care problem. • A significant number have not had access to culturally relevant and effective messages concerning prevention and healthy lifestyle choices. Workers at a landscaping company listen to a presentation on nutrition and physical activity.

6. TARGET POPULATION • Most workers are Latino – monolingual Spanish speaking • Most are foreign born • The majority (62%) of employees are women • Nearly half live below the FPL • Many are in transition and change jobs & addresses

7. TARGET BUSINESSES • Industries targeted by WWLA include garment, food processing and light manufacturing. • Manufacturing industry comprises 13% of the total workforce in Los Angeles. • Focus of WWLA has been on smaller businesses based on the assumption that they are less likely to provide health insurance or benefits to their employees.

8. RECRUITMENT OF BUSINESSES • Strategies used over the years include: • Cold call visits to businesses • Exhibits and presentations to business community • Outreach to business and community organizations • Limited media • Over WWLA’s history, various staffing configurations and consultants have been used to support ongoing recruitment efforts.

9. SERVICES OFFERED • WWLA currently offers services in three main areas: 1) Health Education • Topics include: • Breast and cervical cancer • Nutrition and physical activity • High blood pressure • Sexually transmitted diseases • Health care access 2) Referrals to Community Clinics and County Programs 3) Enrollment Assistance and Follow up • Medi-Cal, Healthy Families, Healthy Kids, etc

10. HEALTH EDUCATION • WWLA brings culturally sensitive and linguistically appropriate preventative health education through presentations and health awareness materials. • Delivered during the worker’s extended breaks or (30 minute) lunchtime • For worksites that do not have lunchroom facilities, presentations are conducted directly in the work area or in outside areas of factories A presentation at Simply Fresh Fruit, a fruit processing company

11. NUTRITION & PHYSICAL ACTIVITY • WWLA adapted the nutrition and physical activity curriculum from California 5-A-Day program specifically for our target population at worksites. • Curriculum was developed into a series of 3 to 5 sessions: • 1) consuming 2 cups of fruits and 3 cups of vegetables a day • 2) grains, milk, meat and beans and oils • 3) weight control and portions • 4) physical activity • 5) summary, evaluation, and award of prizes

12. NUTRITION & PHYSICAL ACTIVITY • Delivery method was upgraded to using a laptop and LCD projector for PowerPoint presentations on the program. • Each presentation was presented in a positive and supportive environment to foster optimal learning. • Each session began with a review of previous topics discussed. • WWLA made healthy food accessible to workers by providing fresh fruit during presentations.

13. LUNCHTIME PRESENTATION

14. NUTRITION & PHYSICAL ACTIVITY • Recipe booklets and other materials were helpful in encouraging healthy alternatives to traditional foods. • Workers commented on healthy recipes and how easy they were to prepare. • One particular area that captured participants’ attention was the alarming fact that Tampico and Sunny Delight are not 100% fruit juice items.

15. NUTRITION & PHYSICAL ACTIVITY • Program emphasized different levels and modes of physical activity discussed in detail. • Workers were engaged in a low-impact dance demonstration during one of our sessions.

16. NUTRITION & PHYSICAL ACTIVITY • Throughout our presentations, trivia questions were incorporated that reinforced key concepts of the food groups. • At the final session of our program, a quiz was included in our Power Point presentation to which workers could respond verbally rather than taking written surveys.

17. NUTRITION & PHYSICAL ACTIVITY • Incentives were provided to WWLA by the Latino 5-a-Day Power Play! Campaign. • Workers were very pleased to receive items, including t-shirts, lunch bags, tote bags and aprons promoting consumption of fruits and vegetables.

18. NUTRITION & PHYSICAL ACTIVITY • Found that nutrition and physical activity are subjects that appeal to the majority of workers. • We were effective in increasing awareness and knowledge of the various food groups among workers as demonstrated in our verbal quizzes conducted throughout our program. • Found that the majority of participants gained and retained the information from our presentations. • Workers commented on our friendly staff and content of our presentations, indicating that the information helped them become more aware of their unhealthy eating habits.

19. COLLABORATION WITH LA REGIONAL NETWORK FOR A HEALTHY CALIFORNIA • In addition to providing nutrition and physical activity presentations, WWLA embarked on encouraging employers to adopt worksite policies supporting workers to make and sustain healthy behavior changes. • WWLA collaborated with the Los Angeles Regional Nutrition Network for a Healthy California Worksite Wellness Program. • Identified a fruit salad processing company (employs 185 employees) eligible to participate in the Network’s program.

20. COLLABORATION WITH LA REGIONAL NETWORK FOR A HEALTHY CALIFORNIA • In December 2007, met with business and made a presentation of program. • Business agreed to participate and assigned a company representative to work with us. • Workplace environmental assessment was conducted. • To begin implementation of the Take Action program and policies based on assessment results, company representative sought to assess employees’ interest in a wellness program and to joining a wellness committee.

21. COLLABORATION WITH LA REGIONAL NETWORK FOR A HEALTHY CALIFORNIA • Employee interest survey utilized by the Network was selected to administer. • After several delays, (it was necessary to translate the survey into Spanish by the Network and the company was dealing with a food recall), the survey was administered in late April 2008. • Fifty-six surveys (30% of 185) were returned. • Results indicated the majority of employees were interested in learning and making behavior changes about nutrition and physical activity.

22. COLLABORATION WITH LA REGIONAL NETWORK FOR A HEALTHY CALIFORNIA • Twenty-five employees also indicated interest in joining a worksite wellness committee. • Company applied to American Cancer Society and Network for a Healthy California for funds of $2,600 to provide incentives for proposed activities. • WWLA assisted company with their application which was approved effective September 2008.

23. COLLABORATION WITH LA REGIONAL NETWORK FOR A HEALTHY CALIFORNIA • Due to several delays on behalf of the company, forming the wellness committee did not begin until October 2008. • At that time, WWLA and the Network met with the wellness committee to review the activities that they would undertake. • Response was very positive. • Since then, the company has not been able to move forward with any of the proposed activities and as a result, funds from the American Cancer Society have been cancelled.

24. CHALLENGES • Seasonal business fluctuations can make scheduling of activities difficult. • Implementation of curriculum at larger worksites is time consuming and complex. • Programs must be culturally and linguistically relevant to the target population. • Participant small manufacturing businesses do not have the staff to establish and implement programs and policies without ongoing support and assistance from WWLA involving a significant amount of staff time.

25. LESSONS LEARNED • Although senior management “agrees” to allow programs and access to workers, do not provide support needed for implementation. • Utilizing the worksite is an untapped venue for reaching a population that cannot afford to take time off from work to seek information. • WWLA’s unique model provides a much needed resource to ensure that this hard to reach population receives current health promotion.