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Lowering Blood Pressure One Worker at a Time

A doctor is checking a woman's blood pressure.

​Carpeting manufacturer Engineered Floors in Dalton, Ga., wanted to control its escalating medical costs without raising health insurance premiums. Through BP First, participants lowered their blood pressure (BP) by an average of 11 percentage points and their body mass index by an average of 0.7 percentage points.

The six-month pilot program was part of a larger wellness initiative, Working for Life, that encourages regular health screenings and simple lifestyle changes—such as adapting healthy eating habits, exercising more and learning to monitor blood pressure at home—to help prevent or manage chronic disease.

"One thing we learned is that our employees would not use their health care [benefits] if they felt it cost too much or it wasn't convenient for them to get to the doctor," said Kaitlin Wade, the company's wellness coordinator. 

Wade, who joined the company in 2017, developed a partnership with the CDC Foundation to create BP First. Employees diagnosed with hypertension or who were on blood pressure medication could opt into the program. Among the 506 employees, 27 of the 216 employees diagnosed with hypertension participated in the pilot. Having health insurance through the company was not a prerequisite for participation.

Participants were given time during their workday to meet with pharmacists at the worksite to discuss their medications, learn to monitor and document their blood pressure, and learn about lifestyle changes that could decrease their hypertension.

"A lot of people didn't realize that sodium intake affects blood pressure," Wade said. "Especially with our population working 12-hour shifts, they were eating a lot of canned soups and frozen meals that have excess salt.

"A pharmacist was able to take the holistic approach and say … 'Let me take your blood pressure. Let me talk about some of the areas you can improve outside of just taking medication,' " she noted.

Participants identified goals they wanted to achieve through the program, such as being active, eating more healthfully, and monitoring their blood pressure and blood sugar.

An employee working as a commercial commissions specialist enrolled with the goal of lowering her BP, her hemoglobin A1C level and her weight.

"I still take blood pressure medicine, but my blood pressure is doing good and [I take] a pill nightly for the blood sugar, which at the time [I began the program] was 8.7. It is now down to 6.0," she said. She asked not to be identified by name for privacy reasons.

The program helped her make better eating choices, she said, and encouraged her to start a walking program. She's been able to maintain the regimen as she continues to work on achieving her health goals.

"I take each day at a time trying to make better lifestyle choices," she said. "I know that my problem is something that I will need to always work on."

Lessons Learned

The in-person approach had to quickly switch to a telehealth model when the COVID-19 pandemic hit. Today, all employees, including those who participated in the pilot, primarily access Working for Life programs on-site, but some programs and services can be provided in other formats.

Since launching the pilot, the company learned it needed to expand its focus to a variety of chronic diseases, Wade said.

"We were able to find gaps in services and programs we are currently offering in relation with hypertension and overall cardiovascular health, to ensure we continue to strive toward providing the most beneficial services and programs to our employees," she said.

Instead of continuing a program focusing solely on blood pressure, "we are going to take what we learned through the program and continue to evolve Working for Life and provide affordable and convenient preventive services to our population," Wade said.

"The goal of Working for Life," said Louis Fordham, vice president of HR at Engineered Floors, "is to remove obstacles that get between an employee and their good health." He and Wade attributed the success of BP First to the company's commitment and a culture of wellness that is based on four pillars:

1. Make it meaningful to employees.

Communicate daily the importance of wellness and remove any barriers that may be preventing employees from seeking care.

"If you are going to go into business where you need people to help accomplish your goals, don't you want them in the best physical and mental state of mind?" Fordham asked. Early detection and prevention were key to improving employee health and ultimately controlling health care costs, he noted.

Wade said regular discussions about overall health helped motivate employees to set health-related goals "and make positive changes that impacted their lives well beyond the workplace."

BP reasons for enrollingjpeg.png

2. Add value for both the business and employees.

Not all of Engineered Floors' wellness and screening programs have been successful, and the company has had to make hard decisions about what to keep. A program must add value to the employees and the organization.

"Anything that we can offer employees that will help them engage in their personal health on their terms and fit their lifestyle, we try to do it," Fordham said. "We believe if we can catch [a health issue] early, or if we can prevent something, everyone benefits."

BP First offered health care at no cost and at the worksite. Health care providers collaborated with the BP First team, the company offered preventive screenings and visits with onsite nursing staff, and participants could work with the wellness coordinator to identify healthy habits.

3. Get leadership on board.

Make the business case that addressing employee health needs prevents them from being off the job because of illness and encourages them to get personally involved.

"Our leaders are some of our highest-use customers," Fordham said, noting that they take advantage of Engineered Floors' programs as much as its hourly employees do. "They then become the champions by just showing up." When they get in line to speak to the pharmacist, for example, it sends a big message to all employees, he explained.

4. Create trusting relationships with employees.

Wade said she makes a point of walking the floor where employees work to drum up support for various Working for Life programs.

"You start a conversation. You get to know the employee," she said. "It all starts with building relationships."

Rachel Ferencik, senior program officer for the CDC Foundation, contributed to this article.


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