Improving Their Own Health to 

Better Serve Others at United Way 

of Pierce County: Case Study

Organization Background 

United Way of Pierce County

« Established in 1953

« Industry: Health Care and 

Social Assistance 

« Location: Tacoma, Washington

« 25 Employees

CS257190L

United Way of Pierce County 

(UWPC) is a nonprofit community 

organization that provides education, 

resources, and opportunities to lowincome families in Pierce County, 

Washington. It partners with local 

nonprofits, businesses, governments, 

and social service agencies to meet 

the community’s most pressing needs. 

The organization is volunteer-driven 

and has a board of directors that 

represents many different sectors of 

the community, including labor, the 

military, nonprofits, and government. 

Its mission is “to work from the heart 

to unite caring people to tackle our 

community’s toughest challenges.”

UWPC applied principles 

of implementing a 

comprehensive health 

promotion program learned 

during the NHWP by putting 

in place a combination of 

programs, policies, and 

environmental supports to 

address multiple areas of 

employee health.

Participating in the CDC’s National Healthy 

Worksite Program

The leadership at United Way of Pierce County (UWPC) saw the 

Centers for Disease Control and Prevention’s (CDC’s) National 

Healthy Worksite Program (NHWP) as a way to bring worksite 

wellness programs to its employees to align with the organization’s 

community-impact areas of health care access and wellness. They 

wanted to lead by example and support UWPC’s mission within their 

own organization.

Despite their interest in the 

NHWP, UWPC leaders were 

not sure if they could apply 

the program’s principles 

successfully because UWPC’s 

Human Resources (HR) 

Department had only one 

staff member. They were also 

concerned about whether 

their staff would buy -in to the 

program and participate in its 

activities. They believed that 

working with organizations in 

their community with similar 

goals would help build the momentum they needed to develop and 

put into place a successful and sustainable workplace health program. 

Rebecca Zimmerman, UWPC’s HR director, worked to get the 

organization accepted into the NHWP in 2013 and led the 

UWPC’s wellness program at its outset. Zimmerman followed 

recommendations from the NHWP and recruited volunteers to form 

a small wellness team. Kelvin Ceasar, project manager for United 

for Military Families, a UWPC program that helps military families 

access services both on and off base, assumed primary responsibility 

for UWPC’s fledgling wellness program about a year after the 

organization began working with the NHWP.

One of the first NHWP activities that UWPC completed was a baseline 

assessment of its employees’ health in 2013. The assessment included 

employee surveys covering health conditions, healthy behaviors, 

and perceptions about the work environment, as well as biometric 

National Center for Chronic Disease Prevention and Health Promotion 

Division of Population Health
screenings. Like all of the employers participating in the NHWP, UWPC also completed the 

CDC Worksite Health ScoreCard, a validated organizational tool designed to help employers assess the extent 

to which they have implemented evidence-based health promotion interventions at their worksites. 

Setting Goals

The 2013 assessment showed priority areas based on the health 

risks most prevalent among UWPC’s employees. The wellness team 

set goals and specific, time-bound objectives to ensure followthrough in two priority areas: nutrition and physical activity. These 

goals and objectives were as follows:

• Goal: Improve nutritional status of employees.

° Objective: Increase the percentage of employees who eat 

the recommended daily allowance of fruits and vegetables 

by 12.5% by March 2015. 

° Objective: Reduce the percentage of employees who are 

at high or moderate risk for high cholesterol by 5% by March 2015. Cholesterol risk is calculated based 

on age, gender, blood pressure, smoking status, triglycerides, and high- and low-density lipoprotein 

cholesterol levels. 

• Goal: Improve employees’ physical activity levels.

° Decrease the percentage of employees who get little or no physical activity by 10% by March 2015. 

Members of UWPC’s wellness team participated in all NHWP trainings and webinars that addressed the main 

developmental stages for a wellness program, which are assessment, planning, implementation, and evaluation. 

Zimmerman and Ceasar also participated in monthly technical assistance calls with CDC staff to share updates, 

solve problems, get advice, and learn how to access resources (e.g., planning tools for campaigns that promote 

walking and stairwell use, model policies for public places). 

After the NHWP training, the wellness team began to meet monthly, usually during lunch breaks. The team 

switched to quarterly meetings once initial program planning was complete.

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“The one ‘aha’ was around fitness. 

Our employees are a fairly mature 

group. They thought about wellness 

more broadly after [the NHWP]. 

Rather than doing more ‘reps’ or 

running, they thought about how 

they can treat themselves well.” 

—Kelvin Ceasar, Wellness Team Chair, 

UWPC

Program Overview

Multiple Strategies to Improve Nutrition

The wellness team focused UWPC’s nutrition 

interventions on education, friendly competitions, 

policy change, and environmental supports. To 

educate employees about nutrition and healthy 

eating, UWPC developed a workplace wellness 

newsletter. The newsletter included wellness tips, 

including some compiled from staff members. From 

spring to fall, the wellness team promoted a weekly 

downtown farmers’ market, located a half mile from 

the organization’s office. The team encouraged 

employees to walk to the farmers’ market together to 

buy healthy produce.

The team also adopted a policy to promote and 

provide fruits and vegetables for all organizational 

meetings and UWPC-sponsored events. Team 

members reviewed the products offered in office 

vending machines and worked with the vendor to 

make healthier choices available. Now more than half 

of the items in the vending machines are “Fit Pick” 

items that meet current healthy nutrition standards 

and include healthy choices, such as green tea. UWPC 

also sponsored a healthy potluck meal and recipe 

exchange during the baseline and follow-up health 

assessments. Employees were able to sample healthy 

snacks after they completed the biometric screening.

An Apple or Two a Day 

The wellness team developed a month-long “UWPC 

Eat an Apple” challenge in February 2015. For each 

apple they ate during the month, participating 
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employees posted a paper 

apple with their name on it 

on a wall in the office. The 

winner received a trophy 

of a carved apple on a 

pedestal. Ceasar reported 

that more than half of UWPC’s 

employees participated. Peer 

pressure helped increase 

participation, and Ceasar said 

employees enjoyed the 

challenge, and he believes 

it boosted morale. 

Getting More Physical Activity at Work 

The wellness team used several strategies to promote 

physical activity, such as walking groups and “active” 

meetings at which employees are encouraged to walk 

and stand instead of sitting. A sign posted outside the 

Human Resources Office encourages people to “Put 

your best foot forward. Use the stairs.”

Helping Employees Reduce Stress

Although stress reduction was not a major focus 

of the first year of the wellness program, UWPC 

provided information and encouraged employees to 

take breaks during the day. The wellness team used 

the NHWP Pierce County Worksite Health Community 

Resource Guide to identify mental health resources 

for UWPC employees. During the holidays, the team 

asked for input from staff and provided resources and 

information on ways to reduce holiday-related stress. 

UWPC’s apple challenge wall. 

Photo provided by UWPC. 

UWPC’s apple trophy. 

Photo provided by UWPC. 

Program Success

After finishing the NHWP in 2015, UWPC completed 

the CDC Worksite Health ScoreCard again as part of 

its follow-up assessment. UWPC nearly tripled its total 

ScoreCard score, from 67 points in 2013 to 195 in 

2015, out of a possible 264 points. The organization 

made improvements in nearly every category, 

including its use of evidence-based interventions 

for nutrition and physical activity, cholesterol, stress 

management, and tobacco cessation.

Some examples of the evidence-based strategies 

UWPC received points for in its 2015 ScoreCard, that it 

did not have in place in 2013, included the following:

• Having a written policy or formal communication

that made healthier food and beverage choices

available in vending machines.

• Having a written policy or formal communication

that made healthier food and beverage choices

available during meetings when food

was served.

• Providing environmental supports for recreation

or exercise.

• Providing organized, group physical activity

programs for employees.

• Providing free or subsidized, one-on-one or

group lifestyle counseling for employees who

were overweight or obese.

• Providing work-life balance and life

skills programs.

UWPC, like many 

other NHWP 

participants, made 

the largest gains 

in its score for the 

Organizational 

Supports module, 

which assesses the 

extent to which 

organizations have 

a foundation and infrastructure in place to support 

and maintain a workplace health promotion program. 

The 2015 ScoreCard score reflected that UWPC’s 

wellness program now has an active wellness team, 

leadership support, and organizational commitment 

at all levels of management, and it is integrated 

into the organization’s annual objectives. These 

improvements helped the wellness team become 

more focused in its efforts to meet its objectives. 

Although UWPC is a small nonprofit with limited 

resources, Ceasar believes the changes noted in the 

ScoreCard have created an environment in which 

employees are more aware of health and wellness and 

more thoughtful about their day-to-day routine.
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0 5 10 15 20 25 30

Organizational Supports

Nutrition

Cholesterol

Weight Management

Physical Activity

Stress Management

Tobacco Control

2015 Score 2013 Score

In 2013, a total of 24 UWPC employees completed 

the baseline health assessment. In 2015, a total of 

25 employees completed the follow-up assessment, 

including 11 of the original 24.

UWPC achieved some but not all of its health 

objectives in the first 18 months of its wellness 

program. Specifically, the organization met its 

objectives for reducing the percentage of employees 

at high or moderate risk for high cholesterol. UWPC 

met its physical activity objective based on a much 

lower percentage of employees who were physically 

inactive in 2015 (36%) compared to 2013 (84%). When 

the data were analyzed for just the 11 employees who 

completed both health assessments, UWPC found that 

the percentage who were physically inactive dropped 

from 82% in 2013 to 46% in 2013. Although UWPC 

did not have a weight-loss goal, the percentage of 

employees in this subgroup who were obese dropped 

from 64% in 2013 to 55% in 2015.

For employees who have been diagnosed with high 

blood pressure or high cholesterol, keeping those 

levels in a healthy range usually involves lifestyle 

changes and taking medication. Increasing the 

number of employees who comply with their doctor’s 

instructions to be treated with medication increases 

the number of employees with their conditions under 

control, reducing their risk for health problems 

and complications. 

The following tables provide the percentages of 

employees with diagnosed high blood pressure 

and cholesterol and the percentages of those who 

are treating their conditions with medication. The 

percentage of UWPC employees treating diagnosed 

high blood pressure and cholesterol with medication 

CDC Worksite Health ScoreCard Overall Score

in Wellness Programming, 2013-2015 2013 Employee Health Issues and Lifestyle Risks Profile

(Employees = 24)

Self-Reported Health Assessment Survey

Eat at least 5 daily servings of fruits and 

vegetables

21%

Engage in little or no physical activity 83%

Health care provider diagnosed high 

cholesterol

13%

Health care provider diagnosed high blood 

pressure

21%

Biometric Screening

Body Mass Index: % obese (BMI >30) 50%

High or moderate risk for cholesterol† 47%

Elevated blood pressure (systolic >140 mmHg 

or diastolic >90 mmHg)

13%

2015 Employee Health Issues and Lifestyle Risks Profile

(Employees = 25)*

Self-Reported Health Assessment Survey

Eat at least 5 daily servings of fruits and 

vegetables

8%

Engage in little or no physical activity 36%

Health care provider diagnosed high 

cholesterol

20%

Health care provider diagnosed high blood 

pressure

20%

Biometric Screening

Body Mass Index: % obese (BMI >30) 42%

High or moderate risk for cholesterol† 43%

Elevated blood pressure (systolic >140 mmHg 

or diastolic >90 mmHg)

44%

*Percentages include all employees who provided data in 2015, 

including those who did not complete the 2013 assessments.

†Total cholesterol/high-density lipoprotein ratio ≥4.0.

stayed about the same from 2013 to 2015. (Note: These 

percentages are based on small sample sizes.) The 

assessments highlighted the need for more education 

to help employees understand the importance of taking 

their medication. As a result, UWPC plans to add these 

messages to its wellness program. 
Page 5 of 6

Percentage of employees treating diagnosed 

high blood pressure with medication in 2013

• Diagnosed and currently taking high blood

pressure medication

• Diagnosed and not currently taking

medications

Percentage of employees treating diagnosed 

high blood pressure with medication in 2015

• Diagnosed and currently taking high blood

pressure medication

• Diagnosed and not currently taking

medications

Percentage of employees treating diagnosed 

high cholesterol with medication in 2013

• Diagnosed and currently taking cholesterol

medication

• Diagnosed and not currently taking

medications

Percentage of employees treating diagnosed 

high cholesterol with medication in 2015

• Diagnosed and currently taking cholesterol

medication

• Diagnosed and not currently taking

medications

40%

60%

40%

60%

60%

40%

33%

67%

“Keeping the healthy stuff at the top of the mind is a 

challenge. [Employees] get wrapped up in work and 

forget that you can’t be a top producer if you are not 

taking care of yourself. They tend to forget about 

being well when they are chasing a fundraising 

number.” 

— Kelvin Ceasar, Wellness Team Chair, UPWC
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Percentage of UWPC Employees Who Agree or Strongly Agree with the Following Statements

2013 2015*

In this facility, management considers workplace health and safety to be important. 83% 100%

My supervisor is concerned about the welfare of those under him or her. 79% 90%

My employer has provided me with the opportunity to:

Be physically active 33% 36%

Eat a healthy diet 33% 68%

Live tobacco free 43% 48%

Work Safely 67% 84

*Percentages include all employees who provided data in 2015, including those who did not complete the 2013 assessments.

Challenges

During the initial months of its wellness program, 

UWPC faced major organizational changes. In 

December 2013, its CEO retired, and several staff 

members subsequently left the organization. These 

changes created a hectic environment, and the 

wellness team was unable to meet for several months. 

The team eventually agreed to meet quarterly, but 

Ceasar said he would like the members to return to 

meeting monthly in the future. 

Another challenge is the weather. In the Pacific 

Northwest, the weather is not always suitable for 

outdoor activities. It rains most days from September 

until spring. As a result, employees tend to be less 

active during the rainy months, and the goal of 

staying healthy often gets lost. In addition, people 

who work in nonprofit social service agencies like 

UWPC are often intensely dedicated to their work. 

When they are working long hours to meet specific 

goals, they can forget to take care of themselves. 

For example, UWPC’s development staff must meet 

an annual fundraising goal, and staff working in the 

community have to turn those resources into positive 

results to ensure the organization’s sustainability. 

UWPC works to overcome the challenge of heavy 

workloads by making sure that health and wellness 

stay in the forefront of employees’ minds and work. 

The staff members are a close-knit, supportive group, 

so if they see each other looking like they need a 

break, they will advise each other to take one.

What’s Next? 

The improvements reported so far have become a 

rallying point for UPWC’s wellness team. It plans to 

use what it has learned about past participation in 

wellness activities to get more staff members involved 

in the future. By drawing on its experience from the 

first 18 months and using the data obtained during 

the NHWP, UWPC’s leaders are confident that they 

can develop activities that will appeal to employees 

throughout the year, and that they can continue to 

improve UWPC’s wellness program. 

The National Healthy Worksite Program was designed to help employers put into action 

science- and practice-based disease-prevention and wellness strategies that would lead to 

specific measurable health outcomes to reduce chronic disease rates. From 2013-2015, each 

participating employer received support, training, and technical assistance to put in place 

a combination of program, policy, and environmental interventions to support physical 

activity, good nutrition, and tobacco-use cessation.