Genesis Research Summit June 8,

 Approximately half of U.S employers offer some type of wellness program  Wellness programs include: ◦ Screenings ◦ Interventions 2

 Employees Greater productivity and energy Incentive to stay with the company Fewer sick days  Company Decrease in health care costs Reduced absenteeism Fewer disability claims 3

 Programs tend to “preach to the choir”  Key - Engage those with multiple health issues that do not participate. 4

Why don’t at risk employees participate given the benefits? And what can companies do to engage them? 5

 Examine why Genesis employees with three or more risk factors for metabolic syndrome choose not to participate in the Genesis Wellness Program or take other steps to improve their health. 6

 Survey Monkey tool used  11 question survey ed to 5,000 Genesis employees post September 2014 screening 7

 Gender – women (80%)  Age Distribution - majority 50 and 59 (30%)  Location – GMC Davenport (33%)  Health Status ◦ Less than 3 metabolic risk factors (61%) ◦ Greater than 3 risk factors (14%) 8

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Deciding to Act and Degree of Confidence ResponseAmount (%) Not acting, not confident2 (0.6) Not acting, somewhat confident 2 (0.6) Not acting, neutral8 (2.3) Not acting, confident4 (1.2) Not acting, very confident5 (1.5) ResponseAmount (%) Undecided, not confident9 (2.6) Undecided, somewhat confident 12 (3.5) Undecided, neutral38 (11.1) Undecided, confident21 (6.2) Undecided, very confident11 (3.2) ResponseAmount (%) Acting, not confident11 (3.2) Acting, somewhat confident 61 (17.9) Acting, neutral41 (12.0) Acting, confident76 (22.3) Acting, very confident40 (11.7) % out of total who said they had three or more metabolic risk factors (n=341) Total of 21 (6%) not acting on their metabolic risk factors 229 (67%) plan to act on their metabolic risk factors 34% confident or very confident 11

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% will not add up correctly because many chose more than one answer 13

Strategies for Success 14

 27% - Family history of risk factors (high cholesterol, diabetes, etc.)  27% - My health is not Genesis’ business  23% - Don’t have time  23% - Don’t need to qualify for Genesis health insurance 15

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 Personal Time  Need to give and do for others  Recognition for achievement  Movement  Sleep  Approval and acceptance  Order and closure of tasks  Time alone  Territory - You need physical space that is your very own  Financial security  Being with people  Anticipation  Competition  Learning something new is stimulating for you  Listening to music  Projects – You like to be creatively involved with ideas  Touching  Variety of experiences  Structured time  Unstructured time  One on one attention  Group relationships  Empathy  Humor  Spirituality  Job satisfaction 18

 The importance of meeting your vital needs is supported.  67% of the respondents with 3+ risk factors believed they could reduce their risk factors  Overly optimistic?  Rationalization?  Those choosing not to improve believed their health was  Unchangeable due to family history  None of their employer’s business 19

People tend to:  Overestimate their ability to change  Overestimate the speed of change  Underestimate the degree of effort required  Not prepare for the barriers encountered  Relapse – and blame their lack of willpower, lack of motivation 20

 Identify and develop strategies for meeting vital needs.  Help participants develop realistic goals and strategies to avoid the traps created by over optimism. 21

 Study those who indicated they were going to make a change and see if they were successful  Evaluate success where goals and skills are more aligned and appropriate  Identify the impact of vital needs on participants with 3+ risk factors and history of failure – i.e. could they reduce their risk factors through realizing their vital needs. 22