Recognition is valid for one year from the date of list announcement. Companies must renew annually by completing a renewal application.

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1 American Heart Association Fit-Friendly Friendly Companies 2012 APPLICATION 2012 Deadlines January 20, 2012 and July 20, 2012 Thank you for your interest in becoming a Fit-Friendly Company! As you know, American adults spend most of their waking hours at work many in sedentary office environments. This makes the U.S. population increasingly susceptible to health risks associated with inactive lifestyles. Studies suggest that by implementing a worksite wellness program and promoting a culture of good health, organizations can: Increase productivity Reduce absenteeism Lower turnover Decrease healthcare costs Encourage employees to live longer, stronger, healthier lives. The American Heart Association is recognizing employers who champion the health of their employees and work to create a culture of physical activity and health in the workplace. Organizations recognized by the American Heart Association will receive recognition and will benefit from ideas to further stimulate their culture of healthy living. The Fit-Friendly Companies recognition program offers companies several ways to be honored on an annual basis. Gold is the first tier of recognition and Platinum is the advanced tier. In addition, the recognition program offers unique Innovation awards for companies that creatively tackle the issue of physical inactivity. Criteria for each tier of recognition and innovation awards were developed by the American Heart Association s Worksite Recognition Volunteer Advisory Panel, consisting of experts in the field of wellness and physical activity. (Please see Page 2 for an outline of criteria.) To be recognized as a Fit-Friendly Company, organizations should take these steps: 1. Develop and implement a measurable, easy-to-follow program to achieve the recognition criteria. Initiatives must be ongoing and in place for 30 days prior to the date of submission. 2. Complete and submit a copy of this application or renewal for currently recognized companies by the deadlines. Applications must be submitted typed in a Microsoft Word document and submitted electronically, via to cherish.hart@heart.org. All applications must be approved by the CEO or equivalent. Recognition is valid for one year from the date of list announcement. Companies must renew annually by completing a renewal application. The American Heart Association will evaluate all applications at its National Center with input from the Worksite Recognition Volunteer Advisory Panel. Local American Heart Association offices will be notified of final decisions and will notify individual worksites. 1

2 CRITERIA FOR START! FIT-FRIENDLY FRIENDLY COMPANIES GOLD Gold recognition is awarded to worksites/companies who meet the following criteria: Offer employees physical activity support Increase healthy eating options at work Promote a wellness culture Employ a minimum of 25 people Implement at least six activities in the Physical Activity area outlined on the application form, at least two activities in the Nutrition area and at least one activity in the Culture area. PLATINUM The advanced Platinum recognition is awarded to select worksites/companies who meet the Gold criteria, plus demonstrate measurable outcomes related to workplace wellness: Achieve all criteria for Gold recognition Demonstrate at least one of the pre-specified positive outcomes in the Behavior Change category, or at least one of the pre-specified positive outcomes in the Cost Savings category, or a positive Return on Investment. INNOVATION Through the Fit-Friendly Companies program, the American Heart Association will recognize companies that inspire change by looking beyond the criteria to truly new and innovative ways to promote physical health. The Worksite Innovation Award is given to a worksite/company that achieves all criteria for Gold recognition, plus demonstrates the development and implementation of innovative and effective efforts that promote physical activity specifically in the workplace. Similarly, the Community Innovation Award is given to a worksite/company that achieves all criteria for Gold recognition, plus demonstrates the development and implementation of innovative and effective programs that promote physical activity not only in the workplace, but also in the community. These criteria apply to all Fit-Friendly Companies recognition and awards: Stated criteria remain the same throughout the year of the application form but are subject to change without prior notice from year to year. The American Heart Association reserves the right to visit worksites/companies to validate the accuracy of information reported in applications, at a time acceptable to the Company. The American Heart Association reserves the right to evaluate each application in its entirety. The American Heart Association s decision regarding the recognition of any worksite/company is final. Companies that receive the award agree that the American Heart Association may include the company name and/or location on its Web sites and in printed materials. The recognition seal, if granted, may be used for a period of one year, beginning at the time of recognition. Companies must re-apply annually. Usage rights are outlined on the next page. Recognized companies will receive detailed guidelines regarding seal usage upon recognition. 2

3 BENEFITS FOR FIT-FRIENDLY FRIENDLY COMPANIES Companies receive benefits as soon as they take the pledge and commit to participating in the Start! program. The program offers employee access to Start! program resources, materials to help promote company wellness programs to employees and consultation on CPR/AED programs. Companies that achieve any level of Fit-Friendly Companies recognition can receive: An official recognition letter sent by the American Heart Association A recognition plaque for display at the worksite Recognition on the Start! program Web site Local-level recognition by the American Heart Association at local events and in communication materials supporting the recognition program; and The right to use the American Heart Association s Fit-Friendly Companies recognition seal for internal communications to employees (e.g., intranet company newsletters, break room posters) and external communications related only to recruitment (e.g., employment section of the company Web site, recruiting tools for job fairs). Please note that the seal may not be used in your company s external marketing, external web sites, public relations or advertising efforts. Platinum level companies may also issue one local press release announcing that they have achieved recognition as a Fit-Friendly Company, in accordance with the Fit-Friendly Companies guidelines, which will be supplied upon recognition. The list of current Fit-Friendly Companies may be viewed at If you wish to see your company listed as a leader in workplace wellness, please apply by completing the application on the following pages. Thank you for your commitment to a healthier workforce. 3

4 ORGANIZATION INFORMATION Please note: Only Microsoft Word versions of the application will be accepted and considered. Please to Company Name/Worksite: FOR AHA OFFICE USE ONLY: Accepted Rejected Comments: Please list EXACTLY how the company name should be listed. This is extremely important as this will be the EXACT name AHA uses for all types of official recognition. For example: if you list XYZ Industries. This is how it will be listed by the AHA. Contact Person: Mr. Mrs. Ms. Dr. Phone Number: Street Address: City: State: ZIP Code: CEO Name: Mr. Mrs. Ms. Dr. Phone Number: Street Address: City: State: ZIP Code: Number of employees at worksite: Number of employees at parent organization (if applicable): Worksite annual gross revenue (check amount): 0-$1M $1M-$10M $10M-$100M $100M-$500M $500M-$1B More than $1B Business Type: Private Public Non-profit SIC Code: Worksite location: Urban Suburban Rural Worksite Environment: High-rise Building Mid-rise Building Low-rise Building Single-level Building AHA Contact Information (To be filled out by company applying who do you work with at the AHA?) Name: Does this application apply to more than one location/worksite? Yes No If so, please complete the information on the following page. Recognition Category Gold (Complete Sections I) Platinum (Complete Sections I &II) Innovation Award Category Worksite Innovation (Complete Sections I, II(if applicable) & III) Community Innovation Complete Sections I, II (if applicable) & IV) Organization Description: (industry, products, organization structure, relationship to the parent, etc.) Branch Locations Applying If you wish for this application to apply to multiple locations, you must complete an additional document in the form of an excel spreadsheet, which should include: worksite name; address; city; state; zip code; number of employees at the site. These locations must employ a minimum of 25 persons, per worksite and meet the same criteria as the headquarters. 4

5 SECTION I GOLD RECOGNITION CRITERIA For each area below, please check all items that apply to your worksite. To receive Gold recognition, a worksite/company must implement at least six activities in the Physical Activity area, at least two activities in the Nutrition area, and at least one activity in the Culture area and must identify a smoking policy. Initiatives must be ongoing and in place for at least 30 days prior to application deadline. Area: Smoking Policy Is your workplace smoke free? Yes No If you answered no, please describe your company s smoking policy: Area: Physical Activity (Check at least six activities.) A. Worksite actively promotes tools such as walking programs, online newsletters, information pamphlets, and pedometers/tracking booklets to motivate employees. Please provide one to two sentences regarding how your worksite implements the above criterion. Please include details about your walking program, including when the program was launched and how often educational materials are distributed. What types of materials are distributed? B. Worksite encourages walking meetings with participation from senior management. C. Worksite encourages employees to take stretch breaks or participate in other physical activities during meetings. D. Worksite has clean, safe, well-lit lit and attractive stairwells accessible to employees during the working hours, and actively promotes their use with point-of of-decision prompts. Also please describe HOW your company encourages usage of the stairways. _ E. Worksite has an indoor walking path with a mile distance marked off, provides a map for safe and convenient walking outside the office or has access to outdoor facilities that allow walking or jogging. Are the walking paths indoor or outdoor? Is signage provided? Do employees receive a detailed map? F. Worksite offers employees a minimum of 12 Sneakers/Workout Attire days a year and encourages physical activity on that day. G. Worksite offers and promotes various physical activity classes (e.g. aerobics, yoga). What types of classes are offered? How often are classes offered? H. Worksite has free onsite recreation or fitness facilities for employees or negotiates discounts with offsite recreation or fitness facilities to offer employees. I. Worksite reimburses employees s for expenses related to the purchase of personal fitness tools/programs. 5

6 J. Worksite offers incentives for increasing physical activity such as physical fitness comp time, flexible spending dollars, or gift certificates to fitness apparel retailers, and incorporates these incentives into employees benefit plans where appropriate. K. Other* (please specify) Please describe in three to four sentences the physical activity initiative you would like considered in the other category. Please keep in mind that initiatives considered in the other category must fall outside of the criteria specified above. Area: Nutrition (Check at least two activities) A. Worksite provides general nutrition education and/or healthy eating information to the employee population, such as a dedicated Web site, newsletters, e reminders and point-of of-service materials in the cafeteria and/or near vending machines, etc. B. Worksite enforces policies that require its cafeteria to offer a minimum of one healthy food option and one healthy beverage option at each meal served. C. Worksite enforces policies that require r company meetings and events to offer a minimum of one healthy food option and on healthy beverage option at each meal served. D. Worksite requires on-site vending machines to offer a minimum of 25 percent healthy food and beverage options. E. Worksite offers discounts that encourage the purchase of healthy food and/or beverages. What types of discounts are provided? F. Other* (please specify). Please describe in three to four sentences the nutrition initiative you would like considered in the other category. Please keep in mind that initiatives considered in the other category must fall outside of the criteria specified above. *Organizations may submit for consideration any additional activities implemented in the workplace other than those listed. However, the American Heart Association reserves the right to determine whether this activity qualifies as criteria for Gold recognition. Area: Culture (Check at least one activity) A. Worksite president or company CEO appoints an internal wellness program coordinator or wellness promotion staff member to be available to employees for consultation. B. Worksite offers employees annual health risk assessments (e.g. blood pressure, cholesterol, BMI, online mental health screening) and provides feedback to employees. C. Worksite organizes and promotes employee health programs, services or classes (e.g. cardiovascular disease in women, stroke warning sign recognition, incentives or competition to increase smoking cessation). What types of classes are offered? How often are classes offered? 6

7 D. Worksite identifies procedures p and develops activation plans to handle employee at-work health emergencies. E. Worksite offers training in CPR, first aid, and /or the use of an automated external defibrillator (AED). F. Other* (please specify) Please describe in three to four sentences the nutrition initiative you would like considered in the other category. Please keep in mind that initiatives considered in the other category must fall outside of the criteria specified above. 7

8 SECTION II PLATINUM RECOGNITION CRITERIA IA (Complete only if applying for Platinum recognition.) To receive Platinum recognition, a worksite/company must achieve Gold recognition and demonstrate at least one of the pre-specified positive outcomes in the Behavior Change category, or at least one outcome in the Cost Savings category, or a positive Return on Investment. A minimum employee program participation level of 50% for the prior year is necessary for consideration of Platinum recognition. Once a worksite has reached an employee program participation level of 90% or higher, it no longer needs to demonstrate a relative 10% increase from that level to qualify for Platinum recognition. ** Outcomes must show greater than 10% increase to be eligible for recognition. Program below refers to worksite health/physical activity promotion programs implemented by your organization. The information provided to the AHA below may be used aggregately, no company specific data will be shared. Outcomes: Behavior Change Category Overall Employee Program Participation (%)* Use of Program Financial Incentives per Employee ($) Purchase of Healthy Food/Beverage Options per Employee ($) Prior Year Current Year Y >10% Relative Increase** Explanation and Supporting Data: Outcomes: Cost Savings Category Prior Year Current Year >10% Relative Change* Sick Days per Employee (#) Turnover (%) Admissions to Hospitals per Employee (#) Workers Comp. Cost per Employee ($) Short-Term Disability Cost per Employee ($) Long-term Disability Cost per Employee ($) Health Care Cost per Employee ($) Health Care Cost as Percent of Pre-Tax Profits (%) Explanation and Supporting Data: Outcomes: Return on Investment Category Return on Program Expenditures Savings and/or Increased Revenue ($) Program Investment ($) ROI (%) Explanation and Supporting Data: 8

9 SECTION III WORKSITE INNOVATION AWARD (Complete only if applying for Worksite Innovation Award. ) Please describe innovative and effective initiatives developed and implemented by your company that promote physical activity at your worksite. Focus your description on the opportunity/problem, solution implemented and measurable outcome.. Provide all relevant data and reports. To receive a Worksite Innovation Award, a worksite/company must achieve Gold recognition and have developed and implemented innovative and effective efforts to promote physical activity at work. The American Heart Association s Worksite Recognition Volunteer Advisory Panel will determine award winners. To be considered, programs must be exceptionally innovative and unique, and provide brand-new examples of creative programming. (NOTE: walking paths or general weight loss challenges are not considered innovative or unique.) Describe Opportunity/Problem Describe Solution Implemented Describe Measurable Outcomes SECTION IV COMMUNITY INNOVATION AWARD (Complete only if applying for Community Innovation Award. ) Please describe innovative and effective initiatives developed eloped and implemented by your company.. Focus your description on the opportunity/problem, solution implemented and measurable outcome.. Provide all relevant data and reports. To receive a Community Innovation Award, a worksite/company must achieve Gold recognition and have developed and implemented innovative and effective efforts to promote physical activity at work and in the community. The American Heart Association s Worksite Recognition Volunteer Advisory Panel will determine award winners. To be considered, programs must be exceptionally innovative and unique, and provide brand-new examples of creative programming. (NOTE: walking paths or general weight loss challenges are not considered innovative or unique.) Describe Opportunity/Problem Describe Solution Implemented ed Describe Measurable Outcomes 9

10 SECTION V SUBMISSION METHOD Please this Microsoft Word document to cherish.hart@heart.org. By submitting this application by , you certify that you have the authority to agree to all terms and conditions of this application on behalf of your company, and agree to all terms and conditions, including but not limited to the following: The American Heart Association reserves the right to determine whether your company meets the Fit-Friendly Company criteria based on the information contained in this application. The American Heart Association reserves the right to withhold recognition if criteria are not met to the satisfaction of the volunteer panel. Note: The fitness programs in which your employees participate might advocate or involve physical activity such as exercise. Such activity is a potentially hazardous activity which may involve physical risks. You hereby expressly agree that your company and its individual employees assume all risk arising out of participation in any company fitness programs. It is the responsibility of individual employees to consult with a physician to determine their fitness to engage in any and all activities associated with company fitness programs. It is also the responsibility of the company and individual employees to use equipment, clothing, and techniques appropriate to the activities related to the fitness programs. You acknowledge and agree that your company is responsible for the safety of employees participating in the fitness programs, and you expressly release and hold harmless the American Heart Association with respect to any claims or damages related in any way to your company fitness programs. Should your company be recognized, you also grant permission for the American Heart Association to use your company name and recognition status in materials regarding the Fit-Friendly Companies program and announcements regarding recognition. You certify that the information contained in this application is accurate and complete to the best of your knowledge. You also certify that the application was reviewed and approved by the CEO or equivalent in your organization. 10