CENTERS FOR DISEASE CONTROL AND PREVENTION
Volume 17 • Number 1 • Fall 2004

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Duke University
Durham, North Carolina

The health of the individual is inseparable from the overall health of the corporation—that is the premise of Duke University’s LIVE FOR LIFE health promotion program, now entering its 16th year. “Cardiovascular disease is a major focus of the program because it has a huge impact on employee well-being, productivity, and health care costs,” explained Julie Joyner, Manager of the LIVE FOR LIFE program.

Studies have documented how LIVE FOR LIFE has boosted employee health and morale while cutting absenteeism, workers’ compensation costs, and health care expenses at Duke. Particularly impressive have been the findings about Duke’s Pathways to Change program, a component of LIVE FOR LIFE that uses telephone, mail, and in-person coaching sessions to help employees control their high cholesterol or high blood pressure.

“Before their first day on the job, employees learn if they would benefit from entering the Pathways to Change program,” explained Ms. Joyner. “We offer health risk assessments as part of our pre-placement screening so that we can identify right away if a new employee is at risk for cardiovascular disease,” she said. “These employees learn about the many resources available to help them enhance their health.”

Over a 1-year period, the employees attend 12 coaching sessions with a registered nurse or registered dietitian. They also receive educational materials and professional blood pressure or cholesterol screenings. The Pathways to Change program is tailored to each employee, depending on his or her readiness to change.

After completing the 1-year program, participants are assessed again to see how their blood cholesterol and blood pressure levels have changed. In a recent evaluation of the program, the results were striking:

• Of the 194 employees who entered the Pathways to Change program with high cholesterol levels in July 2000, 85% cut their risk and 54% became risk-free by June 2001. Duke estimated the program saved nearly $125,000, with a return on investment ratio of 3.29.*

• Of the 185 employees who entered the program with high blood pressure in July 2000, 89% cut their risk and 60% became risk-free by June 2000. Duke estimated it saved nearly $40,000 as a result, with a return on investment ratio of 1.21.*

Ms. Joyner encourages other employers to offer cardiovascular health promotion programs and offers the following advice:

Assess the company’s needs to see what opportunities exist for avoiding costs. “Look for the low-hanging fruit—things that are easy and will give you the biggest return on your investment,” she suggested. For example, the Pathways to Change program helps employees avoid heart attacks and strokes by screening for high cholesterol and then offering assistance to those at risk. The company has saved far more on health care costs than it has had to spend to offer this life-saving service.

Develop an integrated strategy. “Part of the reason that LIVE FOR LIFE is so successful is that it is integrated with our human resources department,” Ms. Joyner noted. The human resources staff members are involved with health promotion, as are Duke’s claims administrators and the network of area physicians who provide care to employees.

Give employees a variety of opportunities to maintain healthy lifestyles. Duke University has many different ways for its 20,000+ employees to participate in health promotion activities—by telephone, online, in personal consultations, or as part of a traditional class. Duke also organizes special events such as the “Lose More in 2004” weight management program. This 12-week program, which focuses on diet, exercise, and behavior modifications, has attracted more than 700 participants this year alone. In addition, Duke’s new Run/Walk Club attracted over 200 employees the first night. Club members have plenty of options, ranging from taking a 5K walk to running a half marathon.

Encourage employees to take an active role in their health. “We try to make it easy and remove the barriers for employees,” Ms. Joyner said, “but they’ve got to be in charge.”

Have fun. From April through September, Duke invites the local farmers’ markets to sell fresh produce and healthy lunches on campus. “Our employees are so overloaded, and for many of them, it’s hard to plan and prepare nutritious meals, given all they have to do in the workplace,” she said. “So we provide a festive atmosphere with music and plenty of fresh fruits and vegetables.”

If the employees won’t come to you . . . “Our strength is that we go out to people to conduct health screenings, assessments, and other services,” Ms. Joyner said. “We have a van to transport our nurses to the multiple different locations that make up the Duke University Health System.”

Evaluate your program. Evaluations will allow you to identify weaknesses and strengths and keep your health promotion program on track. Even though LIVE FOR LIFE is a nationally recognized model program that has won both state and national awards, “we still have our struggles,” Ms. Joyner commented.

*Return on investment = program savings divided by program costs. The Pathways to Change cholesterol control program saved $124,800 and cost only $37,830 to offer. The blood pressure control program saved $39,536 and cost $32,375 to offer. These figures do not take into account, however, the costs for Duke’s larger comprehensive health promotion program, which provides a supportive culture for the Pathways to Change program.

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This page last reviewed August 30, 2004

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