DENSO

While DENSO has maintained a health promotion strategy (Healthy Horizons) for many years, claims analyses from 2014-2016 indicated the program’s average engagement was not effectively reducing common health risks in the employee population. In 2017, DENSO launched a program that features the integration of health coaching into the regular workflow.

Roaming health coaches periodically engage with associates within their normal work environment, thus eliminating the proactive opt-in barrier as well as time barriers that typically limit participation in worksite health and wellbeing programs. Health coach contact has increased from 16 percent of the population annually to 93 percent.

With consistent engagement, coaches can develop relationships and adapt to each individual’s needs, interests, and readiness to change. The model has also connected more employees to other program resources. For instance, health coaches often refer, or direct, employees based on their unique individual needs to relevant disease management, onsite health centers, or EAP.

Contact Person: Brandy Cooper

Email: brandy.cooper@na.denso.com

Evaluation results indicate that the program has yielded significant health risk reduction across the employee population, with improvements in measures of blood pressure, cholesterol, physical activity, diet, sleep, social support, tobacco use, and alcohol consumption. Along with health risk reductions, the company has realized a decrease in medical cost trends for those who engage, as well as reported improvements in musculoskeletal injury rates and employee satisfaction.

• DENSO_ Healthy Horizons_ 2022 Koop Award Application

REVIEWER 1

• Very high meaningful participation: overall rates (93% annual average), coaching participation (76%), 4+ coaching contacts (70%). These are orders-of-magnitude superior to industry averages and a deeper level of engagement.
• Improvements in cohort on 9 measured health risks/behaviors far exceeds standard.
• Substantial cohort shift toward lower overall risk status in Edington multiple-risk analysis.
• Excellent improvement in medical cost trend (flat trend over 3-year period) versus PwC industry trend provides substantial evidence of savings.
• One of the more truly innovative program strategies I’ve seen, focusing on deep integration of health coaches into plant operations and addressing individuals at all stages of change intrinsically. This back-to-the-future strategy highlights the power of understanding the population and integrating health and well-being into the cultural fabric and operations of the organization.

REVIEWER 2

• High participation.
• High self-reported health behavior change.
• Almost half of employees achieved risk reduction.
• Decreasing medical cost trend.
• Innovative integration of on-site coaches.
• Coordination with onsite health centers.
• Good EAP utilization.
• Pre-post cohort comparison.

REVIEWER 3

• Had data to show they needed to change and implemented a pilot before full launch.
• Understood the unique challenges of their population and implemented roaming coach model.
• Provided incentives for HRA completion and biometrics but not coaching.
• Increasing trend in coaching participation.
• Positive outcomes in regard to risk reduction in the 3-year period.
• Although one would anticipate reduced medical claims in 2021 it appears the leveling off began before the pandemic.
• Onsite coaching gained acceptance of line workers.

REVIEWER 4

• From 2018-2021, 75% of employees were engaged with health coaches every coaching cycle – 70%, 4+ times.
• 3 on-site or near-site clinics some of which offer prescription drugs and PT – almost all employees are near clinics.
• Cohort analyses included 5,398 employees for biometrics and 6,725 for HRA analyses (2018-2021) – approximately 48-60% of eligible – offered annually.
• Almost ¾ male population.
• High frequency coach contacts – every 4-6 weeks in 2018 and 8-10 weeks in 2020 forward.
• Employees have access to benefits advocates.
• Lower medical premiums for participation in annual HRA.
• EAP utilization – 17-18% of eligible (2018-2021).
• HRA analysis shows improvements in BP, lipids, PA, diet, sleep, social support, tobacco, alcohol consumption – but negative movement in glucose and BMI.
• Positive risk migration using Edington model.
• Health coaching is integrated into operations.
• Claims data trends look promising.

REVIEWER 5

Health Improvement Efforts:

• Goals for program are clearly stated, with solid information on how data-informed goals were developed. Specific goals were established for coaching encounters.
• Programmatic approach was grounded in scientific principles (readiness to change, memory degradation theory, adult learning theory).
• Programs were made available to entire employee population
• Incentive design seems appropriately balanced with intrinsic motivators in the form of coaches personalizing interactions based on needs, interests, and readiness to change.
• Coaching was embedded into workflow and supported by plant managers.
• Vendor cooperation and cross referrals between coaches, onsite health centers, EAP, and disease management.
• Onsite coaching is supported by web, print, digital education materials. Onsite coaching augmented by phone, text, email, and video calls.
• Focus on “meaningful engagement” in one’s health with 2 levels of engagement specifically defined. Engagement rates were high, exceeding expectations. They improved over time and were compared against an industry benchmark. Percent of employees engaged 4+ times by coaches was very high and improved year over year. Participation rates provided for EAP and Diabetes DM were higher than vendor BoB.
• Use of coaches to help employees complete annual HRA is a great way to initiate engagement.

Participation:

• Levels of participation and engagement were well defined.
• Demonstrated increased participation over time, with industry benchmark comparison.
• Deeper levels of engagement in health demonstrated with supporting information on frequency of contact and quality of interactions.
• Participation/engagement information provided for multiple program components over multiple program years with book of business comparisons provided.

Health Outcomes:

• Impressive risk reduction observed across all measured health behaviors, with 48% - 60% of population represented in cohort with benchmark comparisons made against US BRFSS data. Multiple risk migration analysis supported net risk reduction in a substantial 4-year cohort of population (48%).

Innovations:

• Use of roaming onsite coach model, which was embedded into workflow of operations.
• Use of neuroscience for leadership track to help leaders more effectively respond to stress.

REVIEWER 6

• Comprehensive approach to wellness with branded wellness program and the inclusion of onsite/near site clinics.
• Onsite ‘roaming’ coaches with coaching cycles of engagement is an excellent idea and increased overall engagement. Appreciate the memory degradation theory woven into the program design.  Well done!
• High level of engagement in the program.
• Favorable improvements in health (missing statistical significance). Few factors that did not improve (glucose and body weight) were noted.
• Focus on neuroscience is a positive addition to the program.

REVIEWER 7

• Changed program model based on low participation from high tech to hybrid with significant personal contact.
• Very good coaching participation.
• Adopted model to fit work culture.

REVIEWER 8

• Loved the integration of individual coaching in the workflow for employees. Good engagement, and high coaching participation. Good data supporting health impact.

REVIEWER 9

• The approach of integrating coaching presence and contact into normal workflow, eliminating the proactive “opt-in” barrier, training coaches to be attuned to the local culture are intriguing and innovative. The neuroscience for leadership track is intriguing as well.
• Definitions of levels of engagement are very helpful. Comments about the impact the pandemic provide excellent insight. Participation rates are impressive, especially given the need to shift from an onsite to remote contact approach.

REVIEWER 10

• This is an exemplary program from the clarity of the goals to the data collection and analysis to the outcomes and innovation.
• Clear definition of the levels of engagement (interaction and education), very high levels of both types of engagement sustained over multiple years.
• Demonstrated impact on biometrics and lifestyle risks (using Eddington methodology) showing increase in low and mod groups and reduction in high-risk group in the cohort.
• The implementation and execution of the onsite coaching is a strong element of the program success and innovation.

REVIEWER 11

• Core components of screening/assessment, coaching, DM/EAP, challenges/incentives, etc.
• Innovative evolution to “onsite roaming coaching” to insert education/engagement into everyday interactions (in meetings, breaks, entry/exit, through leaders).
• Improved overall engagement (73% to 93%) and coaching engagement (16% to 75%). High engagement in Diabetes and MSK programs.
• Positive overall shift in self-reported behaviors, and some biometrics (BP/cholesterol).
• Flattening medical cost trend.