Application of Exergames and Technology-Based Weight Loss Intervention in Reducing Obesity Among Great Eastern’s Employees and Increasing Other Benefits
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WRIT001: Academic Writing (Business Research Track) AY2012/2013, Term 2
Title of Essay
Assignment 3: Business Report by Name: Nguyen Huy Phuc Student identification number: G0671469U Group No. G6 Course Instructor: Professor Dawn
I declare that this Assignment is my original work and all information obtained from other sources has been cited accordingly.
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06/04/2013 Date
April 4
Application of exergames and technology-‐based weight loss intervention in reducing obesity among Great Eastern’s employees and increasing other benefits
To Board of Directors Human Resources Manager Marketing Director
Introduction Goh and Pang (2013) state that Singapore has an obesity prevalence rate of 10.8% which is relatively modest compared to obesity-‐plagued countries like the US (32%). However, the BMI cut-‐off of high-‐risk group for Asians is lower than that of Caucasians because of different genetic make-‐ups. This necessitates more concern for obesity in Singapore than statistically suggested, especially when obesity rate has been rising worryingly in the last decade, especially in the age group of 18-‐39 (Goh & Pang, 2013). The majority of Great Eastern workforce is of this group so the company ought to take initiatives to curb obesity (Kurt Nguyen, personal communication, March 1, 2013).
Figure 1: Prevalence of population who are obese (BMI equal or more than 30 kg/m2) by age-‐group and year of National Health Survey (NHS), Singapore. (See Appendix A)
Observation from the preliminary sources suggests that technology can be used to build an appealing platform of physical activity in the form of exergaming and is a reliable measurer of dietary intake and energy expenditure that instills confidence and motivation in obese people to achieve better weight loss outcomes. It is proposed that Great Eastern establishes exergaming facilities to be used by the company’s staff, their families, and customers; and offers subsidized technology-‐based weight management program to overweight and obese employees. This will bring about economic benefits for Great Eastern such as more productive workforce, reduced healthcare cost, lower turnover rate and improved customer retention. The proposal is feasible because of affordable cost of implementation and
participation, participants’ convenience and enjoyment, and actual effectiveness of the program.
Benefits Increased productivity Reduced obesity rate in the workforce leads to increased productivity. Obese people has heightened susceptibility to serious illnesses such as “Type 2 diabetes, cardiovascular disease, obstructive sleep apnea, gallbladder disease, osteoarthritis, and several forms of cancer”, which result in not only increased absence from work alias absenteeism but also hampered performance at work alias presenteeism (Pellegrini et al., 2012). Implementing an effective Workforce Health Program1 (WHP) helps combat obesity, reduce obesity-‐caused absenteeism and presenteeism, produce more consistent performance of the workforce and accordingly improve productivity, as researched by Berry and Mirabito (2011).
DistribuZon Of EsZmated Cost A]ributed To Adult Obesity in Texas, USA 2005 (in millions) Disability ($115.6) 4% Healthcare ($1378.2) 41% Absenteeism $590.7 18% Presenteeism ($1246.5) 37%
Figure 2: An example of what constitute economic loss due to adult obesity, in Texas, USA (See Appendix B)
Reduced healthcare cost Tackling weight problem of employees weakens a key driver of increasing healthcare costs. Obese people are “at least twice as likely to have hypertension, hypertryglycerimia, or Type 2 diabetes as people who are not obese”, diseases which aggravate both mortality and
1
Also called “wellness program”
morbidity2 (Goh & Pang, 2013). Consequently, rising obesity rate corresponds to escalating healthcare usage, which in turn increases healthcare premiums Great Eastern bears to cover employees’ health benefits. This inflated payroll affects Great Eastern’s net profit margin. Implementing the proposal can help alleviate this problem. Barry and Mirabito (2011) highlight an effective wellness program, where 57% of high-‐risk participants were converted to low-‐risk, and those who underwent the program had their medical costs reduced by 48% the following year. The return on investment was 6 to 1. Carrying out a WHP effectively would curb Great Eastern’s spending on employees’ medical costs and produce profitable returns on initial investment.
Figure 3: Savings-‐to-‐cost ratios of Corporate Wellness Programs in the US (See Appendix C)
Better turnover rate A well-‐implemented wellness program augments employees’ loyalty, reduces turnover rate and its ensuing costs for the company. The proposed program includes free usage of exergaming facilities for all employees and their family members, weight loss intervention provided by renowned service provider, and anonymity of participants of such program. Such “encouragement”, “assistance” and “inclusiveness” when instilled in a WHP has “the potential to strengthen an organization’s culture and employee loyalty” since it is “done for
2
the state of being diseased or unhealthy. From http://www.diffen.com/difference/Morbidity_vs_Mortality
employees rather than to employees” (Berry and Mirabito, 2012, p2). Employees will be aware of additional investments or benefits package Great Eastern provides them, apart from basic salary pay and commonplace medical insurance benefits. This creates a competitive advantage for Great Eastern in retaining its pool of talent over competitors who do not have such program. Retention of staff is economically beneficial since it minimizes cost in hiring and training new staff. Such additional wellness program also makes employees feel more valued and boosts their morale, which results in better performance at work.
Figure 4: Comparison of turnover rates between companies with different degrees of effectiveness in Workforce Health Programs in the US (See Appendix D)
Improved customer retention Targeting also Great Eastern’s customers, the proposed wellness program can bring about increased customer retention and its rewards. Great Eastern is promoting its Live Great motto by encouraging customers to adopt a healthy lifestyle with balanced diet and adequate exercise; it is organizing sport activities such as soccer sessions on weekends for customers (Kurt Nguyen, personal communication, March 1, 2013). Allowing free usage of exergaming facilities improves on the current program as it underlines the company’s concern for long-‐term benefits to customers and results in increased customers’ loyalty. It is risky to assume that “there exists an unlimited customer base prepared to maintain patronage” (Surujlal & Dhurup, 2011, p1). Great Eastern needs to “reinvent” itself and forge “long-‐term partnerships” with customers as proposed to improve their loyalty (Surujlal &
Dhurup, 2011). Improved loyalty leads to lesser cost for marketing to “attract new customers”. Retained customers tend to pay higher prices than new customers. As customer term prolongs, “the volumes purchased grow and customer referrals grow” (Surujlal & Dhurup, 2011, p2). Hence the proposed program will increase customer retention and net present value of retained customers.
Feasibility Affordable cost Government subsidies, cost-‐efficiency of exergames, Internet-‐based consultation lower the funding to be borne by Great Eastern. Singapore government is willing to support corporate wellness program with grants to finance “the purchase of related equipment and facilities or incentives that increase participation and motivate behavior change” (Goh and Pang, 2012). Correspondingly, the program aims to reach out to all employees and stimulate passion for sports. Kerssenfischer, Simonsen, Fritsch and Krcmar (2013) found that an important strength cum opportunity3 of the implementation of exergaming in workplace is its cost efficiency. In addition, exergames consist of consoles and controllers which are compact and expend considerably less space than real sports facilities such as a soccer field or a tennis court. Renting of external sports facilities is economically burdensome due to high rates and transportation cost. Thus Singapore’s paucity of space makes exergames a more affordable form of exercising facility compared to that of other sports.
Price of 1 set of console and a game package (in Singapore dollar) 700 600 500 400 300 200 100 0 Xbox 360 Kinect Wii Fit PlayStaion@Move 469 349 651
Figure 5: Prices of 3 most popular exergaming consoles (See Appendix E)
The interview is done on a group of experts of company management using Strength-‐Weakness-‐Opportunity-‐ Threat model to study opinions on implementing exergames in Workforce Health Program 3
Booking fee of one football pitch for a 2-‐hour session on weekends during 1 month (in Singapore dollar) 900 800 700 600 500 400 300 200 100 0 The Cage The Ark Uber Sports Avarage booking Avarage price of 1 fee exergame set 768 680 760 736 $246 more
490
Figure 6: A game set which can serve a lot of players over a span of years is cheaper than four 2-‐ hour 7-‐a-‐side soccer sessions (See Appendix F)
Weight management program participants connect ActiveLink activity-‐tracking device to their computer, upload the activity data online and “receive customized challenges that will gradually increase over time plus activity tips” to enable them to achieve better outcomes ("Electronics”, 2012). Smartphones are considered almost a necessity in Singapore. Thus mobile technology helps provide weight management service with “lower costs, less burden” on Great Eastern and targeted participants since in-‐person consultation is replaced with cheaper yet speedier Internet-‐based consultation (Pellegrini et al., 2012).
Participants’ convenience and enjoyment Participant’s convenience and enjoyment increase the likelihood of targeted participants’ acceptance of the proposed program. Convenience is measured by the ease with which participants keep track of their dietary intake and activity as well as manage their goals. Mobile applications can instantly translate food barcode scans into “PointPlus values”, which are used to estimate the food’s healthy rating ("Electronics”, 2012, p.2). Activity trackers are made “wearable” such that it is convenient to wear them while playing sports or jogging (Pellegrini et al., 2012, p.2). Seamless visualization of activity data on computer or mobile applications results in fulfillment in participants and their motivation to set higher goals. Besides, graphic quality and the realism of “a digital game” are appealing and “absorbent” to the participants, increasing the sense of participation and identity in the game (Charikleia et al., 2011). “Athletic movements” are stimulated by the “playful” context of the games, which correlates to high level of activity since participants are having fun (Kerssenfischer et al., 2013, p.2). Consequently, participants are expected to attend
exergames more regularly and more enthusiastically than traditional exercises. Convenience and enjoyment enhances the feasibility of the proposal.
Figure 7: ActiveLink activity-‐tracking device can be wore comfortably when exercising (See Appendix G)
Figure 8: Friendly interface and appealing language of ActiveLink web-‐based weight management program (See Appendix H)
Recommendations and Implementation Targeted participants Eligible users of exergaming facilities include employees, their family members, and Great Eastern’s customers. Family members are to be accompanied by the relative-‐employee when accessing the facilities. Cooperation with family members is associated with better weight loss outcomes in participants of weight management program (Kerssenfischer et al., 2013). Compulsory accompanying of the employees with their family members limits excessive usage by the family members who are not the primary focus of the implementation. Overweight or obese employees are invited and strongly encouraged to participate in Weight Watchers’ weight management program. Anonymity of the participants will be guaranteed otherwise sensitive people will be discouraged from the program (Kerssenfischer et al., 2013).
Program cost for participants Eligible users can use the exergaming facilities free of charge. Subsidy is provided for the weight management program as a fixed amount valued at 70% of Weight Watchers’ 6-‐ month program to encourage participation. Keeping the subsidy fixed also helps prevent excessive expense in case of overwhelming subscription to the program.
Infrastructure Exergaming facilities are set up in office buildings, thereby minimizing the transportation cost for participants. Close proximity saves the travelling time so that participants have more time to exercise. Lastly, it helps associates the WHP physically and visually with the company’s name because of the immediacy of the working office and the exergaming facilities.
Operation timing Exergames are operational during breaks or up until 3 hours after office hours’ end. The sedentary nature of work necessitates breaks in between such as a lunch break in which participants can play exergames to reduce stress and burn some calories which could otherwise turn into fat (Kerssenfischer et al., 2013). Operating the facilities 3 hours into post-‐working time satisfies the recommended 150-‐250 minutes of moderate intensity activity a week to combat obesity (Goh & Pang, 2013).
Weight management program Playing exergames is a complement to exercises that participants do outside the office using ActiveLink. Exergames, achieving only moderate intensity at the current level of technology, should be used as a complement, not a substitution, to normal exercise (Rizzo, Lange, Suma & Bolas, 2011). (See Figure 9)
Figure 9: Calories burnt during exergames only achieve moderate intensity on average, lower compared to that of real sports (Duration=1 hour) (See Appendix I)
Financial rewards in terms of cash or vouchers will be given to employees who accomplish set goals. Companies, such as Johnson & Johnson, who use financial incentives, usually succeed in encouraging people to join wellness program (Berry & Mirabito, 2011).
Marketing strategies Experts agree that all employees need to be informed of the program so that “success and long-‐term utilization” in the company are ensured. Otherwise, the proposed plan would fail to effect widespread changes on the health status of the employees (Kerssenfischer et al., 2013, p4).
Conclusion Against the backdrop of rising obesity rate and its prevalent harms on the workforce, Great Eastern is strongly encouraged to use exergames as a platform to promote more active lifestyle of its employees; and liaise with trusted service provider to provide weight management program for employees at risk. This will augment both short-‐term profit and long-‐term growth of the company.
Appendix Appendix A: Figure 1 Figure 1 is the results of National Health Survey of Singapore in 2010. Goh , L. G., & Pang, J. (2013). Obesity in Singapore, Prevention and Control. The Singapore Family Physician, 38(1), 008-‐013. Retrieved from http://www.cfps.org.sg/sfp/38/381/SFP%20Vol38(1).Unit1.pdf&ei=yb1WUckVwoasB8-‐ LgMAO&usg=AFQjCNF4Pr9Y94RC-‐MwREqBKd-‐QtxPAS9Q
Appendix B: Figure 2 Figure 2 is from an online report on how adult obesity incurred cost on the economy in the state of Texas, USA. Susan , C. (2005). Weighing The Costs. Retrieved from http://www.window.state.tx.us/specialrpt/obesitycost/2007/05weighingcosts.html
Appendix B: Figure 3 Figure 3 is extracted from this website http://theirf.org/research/content/6078727/energizing-‐workplace-‐wellness-‐programs-‐the-‐ role-‐of-‐incentives-‐and-‐recognition/
Appendix B: Figure 4 Figure 4 is extracted from the report “The Health and Productivity Advantage” done by North American Staying@Work Report in 2010. The link is http://www.watsonwyatt.com/research/render_research.asp?id=NA-‐2009-‐13844
Appendix B: Figure 5 Figure 5 is done personally by the author of this report based on pricing listed on these following websites http://www.sony.com.sg/product/playstation+3+120gb http://www.xbox.com/en-‐SG/index http://www.challenger.com.sg/
Appendix B: Figure 6 Figure 6 is done personally by the author of this report based on pricing listed on these following websites http://2009.thecage.com.sg/bookingrates http://www.ubersports.com.sg/booking.html http://www.theark.sg/2013-‐03-‐28-‐06-‐54-‐36/ratestamanjurong
Appendix B: Figure 7 This image is extracted from Google.com search engine through http://community.weightwatchers.com/LoadDown/Blogs/1c/94/beaf4f1382eb4329843833 1524117667_2.jpg%253Frepository%253D3&w=300&h=400&ei=q3teUYXPFsrqrAfkhYCgCw &zoom=1&ved=1t:3588,r:58,s:0,i:262&iact=rc&dur=1946&page=4&tbnh=200&tbnw=140&s tart=58&ndsp=24&tx=70&ty=61.
Appendix B: Figure 8 This image is extracted from http://www.reducedfatgirl.com/2012/08/weightwatchers-‐ activelink/ .
Appendix B: Figure 9 These data are extracted from http://www.webmd.com/parenting/features/exercise-‐lose-‐ weightwith-‐exergaming and http://www.nutristrategy.com/caloriesburned.htm, and further complied by the author of this report.
References Berry, L. L., & Mirabito, A. M. (2011, April). Partnering for prevention with workplace health promotion programs. In Mayo Clinic Proceedings (Vol. 86, No. 4, p. 335). Mayo Foundation. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3068893/ Goh , L. G., & Pang, J. (2013). Obesity in Singapore, Prevention and Control. The Singapore Family Physician, 38(1), 008-‐013. Retrieved from http://www.cfps.org.sg/sfp/38/381/SFP%20Vol38(1).Unit1.pdf&ei=yb1WUckVwoasB 8-‐LgMAO&usg=AFQjCNF4Pr9Y94RC-‐MwREqBKd-‐QtxPAS9Q Kerssenfischer, F., Simonsen, S., Fritsch, T., & Krcmar, H. (2013, February). Recommendations for the Implementation of Exergames in the Context of Workplace Health Promotion: Results From Expert Interviews. In eTELEMED 2013, The Fifth International Conference on eHealth, Telemedicine, and Social Medicine (pp. 271275). Retrieved from http://www.thinkmind.org/index.php?view=article&articleid=etelemed_2013_15_20_ 40079 Pellegrini, C. A., Duncan, J. M., Moller, A. C., Buscemi, J., Sularz, A., DeMott, A., ... & Spring, B. (2012). A smartphone-supported weight loss program: design of the ENGAGED randomized controlled trial. BMC public health, 12(1), 1041. Retrieved from http://www.biomedcentral.com/1471-2458/12/1041/ Rizzo, S., Lange, B., Suma, E. A., & Bolas, M. (2011). Virtual reality and interactive digital game technology: new tools to address obesity and diabetes. Journal of diabetes science and technology, 5(2), 256. Retrieved from http://europepmc.org/abstract/MED/21527091/reload=0;jsessionid=vQ5XhMPwX7s KIPXrvUvF.18 Surujlal, J., & Dhurup, M. (2011). Customer Retention Strategies in Commercial Health and Fitness Centers. In International Conference on Advancements in Information Technology (pp. 51-59). Retrieved from http://www.ipcsit.com/vol20/41-ICAIT2011G015.pdf
