The New York Times reported findings from a study published in the Journal of the American Medical Association that assessed the effectiveness of a workplace wellness intervention. The study, a randomized trial led by Harvard Medical School, found that employees who participated in the wellness program reported noticeable increases in exercise and active management of their weight; however, the intervention failed to have any apparent impact on employee health outcomes, medical costs or health care utilization over an 18-month period. It also found no effect on employee performance ratings, absence and tenure with the company.
Findings were picked up by CFO Magazine, NPR among others and are likely to reverberate through national, local and trade media in the weeks to come.
Why Your CEO May Care
Your CEO may want to know how your wellness or well-being strategy compares to the intervention highlighted in the study. They may also question the investments your company is making in workplace wellness or well-being and the impact of your initiatives.
The findings from the recent study are the most generalizable to employers with similar workplace wellness program designs. The program included in the study was implemented at BJ’s Wholesale Club in 2015-2016 and consisted of a health assessment, biometric screening and eight program modules led by registered dieticians (RDs) who were employed by the vendor Wellness Workdays. The modules focused on physical health and stress, including “Take Charge of Your Health”, “Nutrition for a Lifetime”, “Maintain Don’t Gain” and “Movin’ in May”; they were scheduled consecutively over 4-7 weeks during the study, with an RD spending an average of eight hours per week on-site. The module content was communicated through webinars supplemented by individual and group activities. Using modest incentives, participation rates varied by module ranging from 12% to 38%.
Although the program design described above may be relevant to some organizations, many large employers have multi-pronged well-being initiatives in place that address various dimensions of employees’ lives, including their physical, mental, financial and social health (see CFO Magazine article). These initiatives leverage programs, policies and benefit design to help employees improve their overall well-being and are inclusive of strategies to create a supportive corporate culture and built environment.
There is recognition among employers with comprehensive well-being strategies in place that the value of their strategy includes – but far exceeds – health care cost savings, particularly short-term health care cost savings, which was the focus of the study. Fifty-nine percent of employers report that one of their top objectives for employee well-being programs is employee engagement and previous analyses indicate that participation in well-being initiatives is tied to this important outcome. Additionally, 27% of employers view their health and well-being strategy as an integral part of their workforce strategy (p. 4, NBGH 2019 Plan Design Survey). A few leading employers have also begun to demonstrate that employee health and well-being can have a positive impact on key performance indicators.
What Employers Can Do
The recent study of BJ’s Wholesale Club’s wellness program is a reminder of the critical importance of design when it comes to the potential effectiveness of a well-being strategy. Employers should consider the following elements when crafting their well-being initiatives.
Customize the strategy to the employee population. The design of an employer’s well-being strategy should reflect the distinct health and well-being needs of the employee population. It should also seek to thoughtfully address specific challenges that employees may face on their road to health and well-being improvement (e.g. financial challenges, challenges related to lack of access to healthy food at home, etc.).
Personalize programs or interventions. Rather than offering one-size-fits all programs, health and well-being improvement initiatives should take into account employees’ personal interests and goals, as well as the needs cited above.
Use evidence-based programs or interventions. Weight management programs, for example, should be high-intensity (>12 sessions per year), delivered in-person, electronically, or in combination, and include peer support and personalization. They should also include maintenance and/or relapse prevention strategies. Evidence indicates that all of these elements are necessary to achieve at least 5% weight loss.
Leverage virtual solutions for lifestyle and chronic condition management. Employers are having success with app-based clinical management and on-demand coaching that aid employees in managing blood pressure, diabetes and weight, for example.
Create a supportive environment. Health promotion interventions need to target both individual behavior and the surrounding environment to be successful. To help employers manage their weight, for example, employers should seek to create a healthy foodscape at work; to promote movement throughout the day, employers should consider the design of their built environment for the ways it can encourage activity throughout the day.
Enlist leaders and champions. Leadership support of employee health and well-being is critical to creating a culture of health and achieving positive outcomes. Across multiple studies, employees’ perception of leadership support and organizational commitment to health has been associated with greater participation in wellness activities, improved health outcomes and greater employee engagement and retention. Well-being champions can also be useful way to promote well-being initiatives and increase engagement across the company.