State-wide partnership celebrates health outcomes

The Weight Management Program, a community-based diet and exercise program, reached 33 counties through approximately 100 fitness centers around the Mountain state.

The innovative arrangement, developed by Public Employees Insurance Agency (PEIA) and managed by West Virginia University, was recognized nationally for the fee-for-service model housed at community-based fitness centers, designed to promote healthy living. PEIA will continue to oversee the program.

Ultimately, WVU College of Physical Activity and Sport Sciences staff helped to enroll approximately 9,000 members in the program.

Sam Zizzi, Dr. Pat Fehl Endowed Professor at CPASS, and his staff personally visited more than 50 fitness facilities to orient and train staff, while holding more than a dozen in person group trainings for fitness and dietary professionals to help provide services to program participants.

“Our professionals provided one-on-one behavioral counseling or medical nutrition therapy to several thousand participants,” said Zizzi.

“Many fitness centers have helped run the program for 10 or more years. The money spent by PEIA on reimbursing services was funneled into local economies so the money stayed in West Virginia. Our fitness partners have been amazing. They put a tremendous amount of effort into helping members achieve their health goals,” Zizzi said.

The program provided a unique opportunity for PhD students to gain practical research and applied training.

“Many of them have used this experience to help prepare for careers in research or academic positions. Throughout the 10 years, a team of 13 professional staff members and 14 PhD students helped to coordinate communication with hundreds of fitness and dietary professionals throughout the state,” he said.

“We produced book chapters, research reports and conference presentations to promote the program, and to present the outcomes associated with participation” Zizzi added.

The idea of an insurance agency reimbursing certified personal trainers and dietitians at fitness centers turned out to be a sustainable model. 

WVU CPASS staff share personal experiences from their involvement with the program

This position had a significant impact on my professional development. I was no stranger to project management, but this project helped me grow those skills to suit a state-wide scale with multiple levels of stakeholders. In the six years I held this position, my project management skills and my managerial skills developed tremendously. I was well-supported by CPASS, Dr. Zizzi and WVU Talent and Culture while I grew as a leader.

I have really loved the view of West Virginia that working with folks across the state can give you. West Virginia is a unique place and I saw that again and again in my work with participants and facilities. I have enjoyed learning about the ways that small rural communities function. Everyone wears multiple hats to meet community needs. Some of the communities the program operated in were small.

So, a participant who is a public employee may also lead the community's search and rescue canine training. Or the city official who manages a community center who participates in our program may also be a 911 operator and lead the community’s youth basketball league. The personal trainer may also be the elementary school principal. I have never experienced that any place else I've lived. There is a sense of ownership and pride that comes through when you work with small West Virginia communities that I have felt truly privileged to experience. I've learned a lot about what's possible from the people in these communities.

The fitness partners’ contribution was significant. The program simply can't run without the dietitians and fitness professionals. The registered dieticians (RDs) provided one on one Medical Nutrition Therapy. Most people don't get access to that level of individualized expertise unless it is specially ordered by your physician. From the start, we were getting people access to that service and setting the expectation that food is important to health. The RDs that work with the program are incredibly skilled, and they must navigate some tough conversations to be effective.

If you think about it, when you're talking to someone about what they eat, you're actually talking to them about a whole host of sensitive things: family culture, family traditions, peer environments, how they spend their leisure time and how they sooth themselves. The RDs talk to people about food, but they are also talking to them about the culture and practices that make up a life.

Our fitness partners also make a huge contribution. They are the face of the program. Fitness staff personally meet with people every month. They are right there with the participant every step of the way. They witness each struggle and achievement. The program was built to foster a relationship with fitness professionals in a participant's community, helping participants access those professionals years from now.

We've seen participants create great relationships with the fitness professionals at their facilities and then long after they are done with the program, they can call on those professionals for additional help. For instance, a participant may have taken up jogging while in the program and years later may work with their local fitness professionals on training for their first half marathon. The fitness professionals give participants a resource to lean on for years to come.

I gained an admiration and appreciation of the work that West Virginia’s public employees perform. They shared their successes, failures, and struggles. Working with the Weight Management Program (WMP) influenced my decision to return to school to obtain a Master’s degree in Public Administration. Although I am no longer working with PEIA on this project, I will continue to be an advocate for WV’s public employees and those working in public administration fields. 

I also developed an interest in project/program management that I hope to continue expanding upon in other career opportunities. In addition, the opportunity work closely with many diverse CPASS Sport and Exercise Psychology graduate students has been really rewarding. It has helped me gain an appreciation for the work that PhD level students perform and the vast amount of knowledge and experience that they contribute.

I’ve enjoyed helping PEIA insured members navigate their health insurance to tap into this wonderful benefit. I’ve enjoyed hearing participants’ success stories and have learned that success is much more than large reductions in weight on the scale. 

Success can be transitioning from Velcro shoes to shoes that tie, being able to independently fasten the seatbelt or go grocery shopping, taking the stairs without becoming winded, being able to get on the floor to play with your children or grandchildren, being able to walk in and confidently use the fitness center when it was previously too intimidating to even get out of the car, avoiding invasive medical procedures like joint replacements or bariatric surgery and/or being able to stop taking prescription medications that one had been taking for years. 

I’ve enjoyed helping our community partners navigate the insurance side of the WMP benefit and have enjoyed helping them work with people who may be somewhat different from their regular clientele. I’ve developed connections with dietary and fitness professionals whom I probably would not have developed had I not had the opportunity to work with this program.

Dietitians and fitness professionals have used their expertise to shape program curriculum. In addition, their work is what makes the program, and, in my opinion, there wouldn’t be a WMP benefit without their efforts. They are the ones meeting with, connecting and educating PEIA members toward making healthy, sustainable lifestyle change. Their knowledge and expertise has helped many PEIA insured members meet their dietary and fitness goals. Their continued willingness to partner with PEIA and the WMP affiliated fitness centers have been crucial to sustaining the WMP for many years.

Working with the PEIA Weight Management Program has broadened my areas of expertise in medical nutrition therapy and allowed me to change the focus of my career. Instead of working with patients who are so ill that they are hospitalized or institutionalized, I could help people improve their health in hopes of avoiding chronic or catastrophic illness. It was a way to bring the joy of healthy eating and lifestyles to the people we serve. 

Working with participants both face-to-face in facilities, and in my current position has helped develop my counseling skills and become a better RD. It also helped me create a network of professionals around the state with a common mission-to improve the health of West Virginians through food and nutrition. It was also a way to increase our reach as dietitians, being able to help more people in more places in our communities.

What I enjoyed most about working with participants was the relationships that were created, and the excitement that was shared when they were successful, no matter how small or large that success may have been. Our community partners were fantastic. I felt like we were a team working with people to improve their lives.

Most participants told me daily how our program and the professionals they interacted with (RDs, behavior counselors, and fitness professionals) have helped them. I always heard, "I feel so much better. I didn't know I could feel like this." That takes team work, and even in a large state-wide program like ours, our teams worked together to achieve a common goal for our participants.

The biggest contribution we have all made, is that we have changed lives for the better. We have helped people discover the joy of healthy eating and of physical activity in their lives. RDs have helped people address their medical conditions through nutrition counseling that may not have otherwise been made available to them. We have helped people make practical changes to what and how they eat in their daily lives to help manage their weight and improve their health. Fitness professionals have helped people enjoy being active again, or start being active if they never have been. Most people who leave the program decide to stay on as a member at their gym. Something is sinking in.

This program has been a joy to work with. We have touched thousands of lives and have had a significant impact on those we have served.