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Employee Wellness Program Outcomes: A Case Study

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The unhealthy behaviors of the U.S. workforce have been leading to steep increases in employer health costs. In an attempt to combat these rising costs, some employers have begun proactively sponsoring employee wellness programs. However, often their efficacy remains unstudied. In this article, program outcomes associated with wellness efforts at a large midwestern-based manufacturing company, focusing on workers' physical health, are examined. The program under study recently reached its one-year mark after inception; therefore, data collected within this article will be among some of the first indicators actively consulted to determine the success of this employee wellness program.
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Employee Wellness Program Outcomes: A
Case Study
Jason S. Swayze MS a & Lisa A. Burke PhD, SPHR b
a College of Engineering & Computer Science, University of
Tennessee at Chattanooga, Chattanooga, Tennessee
b College of Business, University of Tennessee at Chattanooga,
Chattanooga, Tennessee
Version of record first published: 11 Feb 2013.
To cite this article: Jason S. Swayze MS & Lisa A. Burke PhD, SPHR (2013): Employee Wellness
Program Outcomes: A Case Study, Journal of Workplace Behavioral Health, 28:1, 46-61
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46
Employee Wellness Program Outcomes:
A Case Study
JASON S. SWAYZE, MS
College of Engineering & Computer Science, University of Tennessee at
Chattanooga, Chattanooga, Tennessee
LISA A. BURKE, PhD, SPHR
College of Business, University of Tennessee at Chattanooga,
Chattanooga, Tennessee
The unhealthy behaviors of the U.S. workforce have been leading to
steep increases in employer health costs. In an attempt to combat
these rising costs, some employers have begun proactively sponsor-
ing employee wellness programs. However, often their efficacy
remains unstudied. In this article, program outcomes associated
with wellness efforts at a large midwestern-based manufacturing
company, focusing on workers’ physical health, are examined. The
program under study recently reached its one-year mark after
inception; therefore, data collected within this article will be among
some of the first indicators actively consulted to determine the suc-
cess of this employee wellness program.
KEYWORDS wellness programs, worker physical health, program
outcomes, case study
In the modern competitive environment, companies are now starting to
understand the importance of employee wellness. Although a more holistic
view of wellness goes beyond the absence of disease and encapsulates indi-
viduals’ physical, psychological, social, and spiritual health (World Health
Organization, 1946), this article focuses on the physical component. The
need for intervention is in large part due to the steep rise of health care
costs. With most adults admitting that they receive little to no physical
Address correspondence to Lisa A. Burke, PhD, SPHR, College of Business, University of
Tennessee at Chattanooga, 615 McCallie Ave, Chattanooga, TN 37403, USA. E-mail: lisa-burke@
utc.edu
Journal of Workplace Behavioral Health, 28:46–61, 2013
Copyright © Taylor & Francis Group, LLC
ISSN: 1555-5240 print/1555-5259 online
DOI: 10.1080/15555240.2013.755448
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Employee Wellness Program Outcomes 47
activity during their typical workday (Khazan, 2011), which underlies many
health-related illnesses, this means the unhealthy living flag must be thrown.
In an attempt to develop and maintain a healthier work environment, many
progressive companies, such as Johnson & Johnson along with Kaiser
Permanente and numerous health-related organizations, have begun spon-
soring employee wellness programs as a proactive solution (Cunningham,
Weathington, & Burke, 2008).
Workplace wellness programs generally include any health promotion
intervention, policy, or activity in the workplace designed to improve health
outcomes of workers (Lee, Blake, & Lloyd, 2010), although we know little
empirically about various programs or their associated outcomes (Csiernik,
2011). Common examples of wellness initiatives include educational endeav-
ors such as newsletters or seminars, health coaching, health screenings,
health-related fairs, on-site fitness facilities, and/or healthy food options in
vending machines (Lee etal., 2010). Often employers will offer incentives to
encourage workers to participate; in fact, recent survey findings suggest that
close to 73% of employers use some type of incentives to engage employees
in health improvement programs (Miller, 2012).
One of the greatest reasons for this difficulty comes from the general
acceptance that employee wellness programs can produce attitudinal and
behavioral benefits (Baicker, Cutler, & Song, 2010). However, it often is hard
for companies to monetize the exact benefits that an employee wellness
program can provide, and some companies do not even attempt to try it at
all (Csiernik, 2011). Even if a company can identify all the major benefits to
observe, finding ways to gather and quantify this information becomes chal-
lenging. In many cases this information just does not exist because the com-
pany has never collected the desired data. Another common roadblock exists
when a company can produce the data; however, the quality is so poor that
it provides little or no use for the company.
So why is it important that a company examines the return on invest-
ment for its own wellness program? With any sizable investment being made
it is important to be able to show positive effects as well as to avoid a situa-
tion where a beneficial wellness program gets cut for cost savings due to its
inability to prove its own worth. If the studies conducted on a firm’s wellness
program show virtually no effects at first, we contend this information is still
of value because it may provide an opportunity to restructure the wellness
program to achieve the desired results before funding is abandoned (Wellness
Council of America, 2007).
The purpose of this study is to evaluate whether implementing an
employee wellness program can generate benefits for employers and employ-
ees. Within this article the common attitudinal and behavioral benefits of
employee wellness programs are summarized based upon the extant litera-
ture. The current case study then examines one specific wellness program’s
results by utilizing information provided from a large midwestern-based
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48 J. S. Swayze and L. A. Burke
manufacturing company that has already taken the needed steps to adopt a
widespread employee wellness program. Specifically, we report on employee
participation and improvement in biometric measures associated with the
interventions introduced. We also step into a relatively unexplored area in the
literature and report how an employee wellness program may affect work-
place safety outcomes.
POTENTIAL BENEFITS OF EMPLOYEE WELLNESS PROGRAMS
The components of employee wellness programs can vary greatly from com-
pany to company, but the expected benefits that are sought remain similar,
ranging from decreased health care costs (Berry, Mirabito, & Baun, 2010;
Capps & Harkey, 2008) to reduced absenteeism and turnover (Miller, 2010;
Poll, 2006) to enhanced productivity and company image (Baicker etal.,
2010; Lee etal., 2010). Even though each wellness program has its own set
of unique initiatives, the most common components revolve around medical
screenings or surveys, wellness education programs, and exercise programs
(U.S. Office of Personnel Management, n.d.). Medical screenings are usually
aimed at locating any serious health conditions and coaching employees
toward improvement. That is, wellness education programs can then provide
employees with information and knowledge pertaining to a healthy lifestyle
(e.g., dietary, fitness, smoking cessation, stress reduction). Exercise programs
focus upon getting employees active; this is commonly done by providing an
on-site fitness center, or access to one, allowing employees to exercise and
stretch within a convenient location.
The benefits provided from company-sponsored wellness programs
can be attitudinal and behavioral, as described in the next section. That is,
wellness programs have the ability to change the way people feel about their
work environment (attitudinal) and also change the way people perform
their work (behavioral). As attitudinal refers to something you feel, these
benefits are considered less tangible (Lee etal., 2010), which makes them
more difficult to quantify, although are still valued by firms. However, per-
forming studies on observable work behaviors can be easier to quantify and
provide a way to measure the organization’s progress toward achieving its
objectives (Burkholder, Golas, & Shapiro, 2007).
Potential Attitudinal Benefits
IMPROVED EMPLOYEE MORALE
One way to improve morale is to show employees that the company actually
cares about their best interests. When upper-level management gives their
support to employee wellness programs, a positive message can be sent that
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Employee Wellness Program Outcomes 49
they care about the health and well-being of their employees. In return, this
may prove to increase employee morale (O’Reilly, 2006). Indeed, it can be
difficult to develop healthy trust relationships among employees when their
only contact with each other comes from the typical day-to-day work opera-
tions. Employee wellness programs consequently provide an opportunity for
morale enhancement by having groups of employees set health goals and
work with each other to achieve those goals. In turn, group norms in the
organization surrounding and supporting healthier lifestyles should
crystallize.
IMPROVED COMMITMENT TO THE ORGANIZATION
If a company is to expect a strong commitment from its employees to con-
stantly perform at their best, then in return the employees will desire a
strong commitment from their company. One commitment that a company
can make to its employees is to improve and maintain their personal well-
ness. According to research, employees who are committed to their organi-
zations exert more effort, go to greater lengths to help coworkers, and offer
more creative ideas for organizational improvement (as cited in Dyck &
Neubert, 2008). In fact, employers such as Badger Mining Company (Dyck &
Neubert, 2008) have initiated wellness programs, at least in part, to explicitly
enhance employees’ commitment.
Potential Behavioral Benefits
IMPROVED EMPLOYEE PRODUCTIVITY
Healthier employees should be better equipped to combat fatigue and
handle the day-to-day stresses caused from the typical work environment
(Isaacson, 2010). With a greater ability to handle stress and fatigue along
with being physically healthier (Klitzman, House, Israel, & Mero, 1990),
employees can be more productive by being able to work efficiently and
consistently through the entire work day. Put simply, increased worker pro-
ductivity is an associated benefit of wellness programs often sought by
employers (Lee etal., 2010).
DECREASED ABSENTEEISM
Research shows that healthy employees tend to miss fewer days from work
due to illness (Miller, 2010), which is highly valued by employers. Another
related outcome is that employees who condition themselves to make healthy
life decisions may try to get family members involved in the same practices.
As such, healthier employees may miss fewer days from work having to care
for sick relatives.
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50 J. S. Swayze and L. A. Burke
DECREASED TURNOVER
Turnover is expensive and is usually a result of a company that fails to meet
the needs of its employees (Poll, 2006). With health being one of the more
critical needs of employees, having a wellness program may have a positive
impact on employee retention. It could also be harder for employees to
leave when they are committed to an employer who has invested in their
overall well-being; indeed, increased commitment leads to lower turnover
(Dyck & Neubert, 2008).
IMPROVED SAFETY BEHAVIOR
One understudied potential outcomes of wellness programs is improved
safety records in the workplace, given enhanced employee health and well-
being. Employees who are healthy should have increased ability to focus on
the task at hand as well as fewer risk factors for injury than unhealthy
employees. If employees are physically and mentally healthy, their attention
to detail should also be increased when producing work outputs. Without
the stress and limitations imposed by sickness, healthy employees should be
positioned to contribute more to the organization’s valued outcomes. The
relationship between worker health and safety has been documented in the
literature (Danna & Griffin, 1999).
Potential Organizational-Level Benefits
DECREASED HEALTH CARE COSTS
Put simply, healthy employees have fewer health-related problems thus
reducing the costs of employee health care, a topic of extensive coverage in
the popular media and practitioner literature. Many studies have been done
in this area, and the majority of current analyses indicate that for every dollar
spent on wellness programs, a company should expect to save anywhere
from $2 to $6 in health care costs (Berry etal., 2010). This is the type of hard
data that top managers want to know of before embarking upon a wellness
imitative.
DECREASED WORKERS’ COMPENSATION CLAIMS
Workers’ compensation claims can occur as the result of serious safety-
related incidents. Because healthy employees have fewer risk factors, the
chance of a serious safety-related event occurring can be reduced, thus mini-
mizing the chance of having a workers’ compensation claim filed. Furthermore,
even if a workers’ compensation claim does get filed, healthier employees
typically recover more quickly, which could reduce the timeframe that the
company will have to pay out disability benefits.
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Employee Wellness Program Outcomes 51
ENHANCED COMPANY IMAGE
A lot of what creates the image of a company is how much it cares about
and treats its own employees. As previously cited, the support of wellness
programs is one way that a company can send a message that it cares about
its employees, thus enhancing its image (Lee etal., 2010). That is, if employees
are happy to work for a certain company then this sends a positive message
to the public, thus enhancing the company’s representation in the prospective
applicant pool and community at large. Consequently, this outcome could
have positive effects when trying to recruit workers (Baicker etal., 2010).
Potential Financial Benefits
When spending money on employee wellness programs, companies want to
see that their investment is generating positive returns. Indeed, more organi-
zations are demonstrating positive return on investments (ROI) on wellness
interventions than ever before (Capps & Harkey, 2008), and the current lit-
erature on employee wellness programs is filled with many ROI studies from
various companies. A meta-analysis consisting of 22 different studies was
conducted and published by Baicker etal. (2010). The authors selected the
studies to include by using three criteria:
1. They had a well-defined intervention.
2. They had a well-defined treatment and comparison group, even if the
comparison group was not strictly randomly assigned.
3. They represented analysis of a distinct new intervention, rather than fur-
ther analysis of an intervention already examined in one of the other
studies.
Upon analysis of the 22 studies, an average savings per employee per year
for a physical wellness program in terms of health care costs was $358,
whereas the average costs per employee per year were only $144. Thus, the
average program had a return on investment of nearly 148% [(Net Benefits/
Costs) * 100].
CASE STUDY
Background
The data that were collected for this study came from a large Midwest-based
manufacturing company that operates globally. This company has recently
implemented an employee physical wellness program across the United
States in the form of a pedometer program. This program allows participants
to track their daily activity levels along with certain biometrics such as blood
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52 J. S. Swayze and L. A. Burke
pressure. The information that is collected from employee pedometers is
uploaded through designated wellness kiosks, which are also equipped to
conduct biometric scans. Notably, these kiosks exist at every U.S. location,
thus allowing the appropriate wellness leaders to track the success of this
new program.
As of October 2011, the pedometer program was exactly one year old.
Data were collected from the wellness and safety leaders within the com-
pany and focused on the comparisons of baseline data collected during the
month prior to the inception of the pedometer program compared to infor-
mation collected one year later.
The data used for this study were provided by the wellness and safety
leaders within the company, as generated from information stored on the
wellness kiosks’ hard drives. The actual data collected for this study required
near-zero human manipulation to produce and organize due to the ability to
set data retrieval parameters when having the wellness kiosks perform
searches on the stored data. The input data used to create the graphs are
unaltered versions of data provided by the wellness kiosks.
Participation in the Wellness Program
For this company’s wellness program, 55% of employees enrolled, and 89%
of those employees uploaded their pedometer activity so that it could be
tracked and recorded (see Table 1). Fifty-six percent of the participants were
male, and 53% were between ages 30 and –49. Of those who participated,
69% were employees and the remaining were employees’ spouses.
Participant Pedometer Activity
Activity level is an important variable when it comes to predicting worker
illness. That is, one of the strongest controllable predictors of total health
care costs to organizations appears to be an employee’s activity level, and
this factor becomes increasingly strong as individuals age (Wilkerson, Boer,
Smith, & Heath, 2008). As such, gathering information on physical metrics is
an important dimension to capture when evaluating wellness programs.
Thus, we report participants’ pedometer activity levels in Table 2. (Note:
TABLE 1 Program Participation
Currently enrolled members in the Wellness Program 15,070
Employed at this firm 18,906
Overall company enrollment 10,398 (55%)
Members uploading pedometer activity 89%
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Employee Wellness Program Outcomes 53
Table 2 would benefit from pre–post comparisons. However, we do not have
reliable estimates of preintervention data, which we note is a limitation.)
The surgeon general’s recommendation is to accumulate 30 minutes of
activity for most days throughout the week. Taking 10,000 steps in a day is a
rough equivalent to this recommendation and should be enough to reduce
the risk for disease and help to lead a healthier, longer lasting life (McDowell,
2011). As can be seen from Table 2, 47% of participants were taking 7,000 or
more steps a day.
Table 3 displays the definitions for each category of physical activity.
For example, to be categorized as High Active, a participant would have to
log more than 300 minutes of physical activity (i.e., walking and running) on
a weekly basis. These definitions provide the basis for interpreting Figures 1
and 2.
Even though there were 15,070 members enrolled in the pedometer
program in October 2011, the data reported represents only 9,368 members
(64%), or the number of people who had been continuously enrolled in the
12-month period. This was a result of the company introducing the initiative
through a rolling implementation, and thus not all of the employees were in
the program on October 1, 2010. Some members did not start until months
later during the 2011 period. So to appropriately track change in activity, we
only examined participants who had been enrolled for the entire time period.
TABLE 2 Participants’ Pedometer Activity Levels
Average steps per day # of members % of members
Median average
steps/day
<7,000 steps per daya7,936 53% 3,795
7,000–12,000 steps per day 5,777 38% 8,944
12,000–20,000 steps per day 1,227 8% 14,277
>20,000 steps per day 130 1% 24,512
aIncludes members who have not yet uploaded or activated pedometer.
TABLE 3 Defining Physical Activity Levels
Categories of physical activity
High Active: 300+ minutes
Active: 150–299 minutes
Low Active: 60–149 minutes
Inactive: 1–59 minutes
Not Uploading: No activity uploaded
Note. Program members are categorized according to the
amount of moderate physical activity, e.g., walking &
running, that they uploaded on a weekly basis.
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54 J. S. Swayze and L. A. Burke
The data in Figures 1 and 2 show the shift in participant activity after being
enrolled in the pedometer program for one year. In other words, Figures 1
and 2 show baseline and end-of-period data.
Results indicate that the percentage growth among the number of par-
ticipants who are currently meeting the surgeon general’s recommendations
was 17%. The total percentage of participants currently meeting the surgeon
general’s activity recommendations is 67%. Notably, the total percentage of
Low Active members who shifted into the Active and High Active categories
was 55%, whereas the total percentage of Inactive members who shifted to
Active or High Active was 30%. Finally, the total percentage of Low Active
and Inactive members who shifted into the Active and High Active categories
was approximately 45%.
FIGURE 1 Physical activity level before versus after pedometer program. (Color figure avail-
able online.)
FIGURE 2 Physical activity level before versus after pedometer program. (Color figure avail-
able online.)
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Employee Wellness Program Outcomes 55
Biometric Measures
In Figure 3, biometric measures are reported to show the shift in blood pres-
sure readings among 205 participants. That is, Figure 3 shows baseline and
end-of-period data. For these measures only individuals who had taken a
blood pressure check at one of the kiosks in October 2010 and then had
taken another reading at least one year later were examined. As only a lim-
ited number of kiosks were equipped to check blood pressure at the start of
the pedometer program, the population is rather small (n = 205, representing
1.97% of the total company enrollment).
Results indicate the total percentage growth among the number of par-
ticipants falling within the ideal blood pressure category was 15%.
Impressively, the total percentage of Prehypertensive members who shifted
into Ideal was 57%, whereas the total percent reduction in Hypertension 1
members was 64%.
Furthermore, results indicate that the total percentage of Hypertensive
1 members who shifted into Ideal was 24%, whereas the total percentage of
Prehypertensive and Hypertensive 1 members who shifted into the Ideal
category was 4%.
Safety Outcomes
Given the dearth of safety-related outcomes reported in the literature with
wellness programs, we wanted to solicit some exploratory information in
this area. The safety data that were collected came from multiple manufac-
turing-oriented business units and safety leaders within the company who
were utilizing the pedometer program. The largely anecdotal data show the
shift in safety among the observed business units since the implementation
of the pedometer program.
FIGURE 3 Biometric measures before versus after pedometer program. (Color figure avail-
able online.)
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56 J. S. Swayze and L. A. Burke
BUSINESS UNIT 1
In the first business unit studied, the safety leader stated,
There has been a significant improvement in safety since the implemen-
tation of the pedometer program one year ago. I am not sure how much
we can attribute this improvement in safety performance to the improved
general health of employees although I can see how it would impact it.
In particular, this unit reported: a 53% reduction in recordable injuries, 73%
in lost workday cases, 83% reduction in lost workdays, 74% reduction in
Occupational Safety and Health Administration (OSHA) DART (Days Away,
Restrictions and Transfers) cases, and finally 80% reduction in DART days.
BUSINESS UNIT 2
When collecting information from the second business this safety leader
stated,
Since the start of the pedometer program, I have noticed employees
walking more in the parking lot and around the plant during breaks and
lunch. I can only believe this has made a difference in employees being
more fit and alert, thus a higher focus on the tasks being performed.
This business unit contains the largest populations and plants within the
company; therefore, any observed reduction in injuries within this business
unit can generate sizable savings for the company. Specifically, this unit
reported a 20% reduction in recordable injuries.
BUSINESS UNIT 3
When looking into the final business unit for this study, this safety leader
stated,
We have seen a much improvement this year over last year on OSHA
recordable injuries. During the year prior to implementing the pedometer
program we had twenty recordable injuries and now one year after
implementation this number is down to nine. I feel like the pedometer
program has really promoted our employees to be much more aware of
their state of health. I myself actually won a contest this year and was
awarded $300.00 from Corporate.
Notably, this unit reported a 55% reduction in recordable injuries.
Even though all three safety leaders in this study seemed to indicate
that the wellness program played a role in reducing the amount of record-
able injuries, they were also unable to quantify exactly how much. When
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Employee Wellness Program Outcomes 57
asked if other potential safety interventions were implemented during this
time frame the safety leaders all stated,
The plants assessed their risks based on trending data from previous
years and developed detailed safety plans to mitigate, control or elimi-
nate the risks. We also implemented a couple of toolkits on ergonomics
and hand safety. Machine guarding assessments were conducted, and we
alsoimplemented a near hit reporting process to include investigation
and closure of corrective actions. There was much work done during this
past year.
Clearly, these other interventions would play a role in improving safety
outcomes, and so the safety improvements attributed to the wellness pro-
gram in this study cannot be isolated. In a final statement, the safety leader
from the first business unit in this study said, “I am confident that the
improved health of our employees contributed to the reduced injury rates;
however, I am at a loss for just how much.” Given the nature of the safety
data in this study, in no way are we able to attribute the reduction in injuries
to the implementation of a wellness program; however, given the involved
safety leaders’ comments a perceived need exists for such a scientific study.
IMPLICATIONS FOR EMPLOYERS
The employee wellness program in this study was able to generate impressive
participation that consisted of more than half the current U.S. employee base
(i.e., a significant sample size), along with many eligible spouses. With this
high participation, the data collected were able to illustrate significant shifts in
activity among employees, which translated into healthier worker lifestyles
and improved biometric measures. Specifically, as this case study demon-
strated, the use of a pedometer can be a powerful tool for companies when
trying to assess and improve the physical activity level among employees.
However, there are certainly limitations with this study, as there are with
any study. Future studies could be improved by utilizing an experimental
design using a control and intervention group and longitudinally gathered
time series measures. Also, researchers may want to isolate and measure the
intervening variables to see in better detail how much walking and running
generates safety improvements. For example, studies could measure alertness
before and after walking around the plant during breaks, compared to a con-
trol group’s pre- and postmeasures. Evidence would then need to be found
that supports increased employee alertness after walking to fully conclude
this as an attribution to the safety improvements. Finally, given that the ROI
for employee wellness programs do not appear until about 3 to 5 years after
inception (Hendrickson, 2011), it may currently be too early to perform an
accurate ROI study on this company’s year-old employee wellness program.
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58 J. S. Swayze and L. A. Burke
Nonetheless, we believe the inclusion of spouses in wellness programs
merits serious consideration by employers. According to Hall (2006),
Improving health behaviors of spouses and children of employees can
yield significant additional health cost savings, as well as provide
additional motivation and support for employee lifestyle changes outside
of the work environment in many families, the spouse may have the
greatest impact on lifestyle factors. (p. 22)
Hall went on to encourage employers to involve spouses by inviting employ-
ees’ family members to participate in employer-sponsored health fairs, educa-
tional seminars, and other wellness-related activities hosted by the employer.
Successful Wellness Program Attributes
Generating employee participation in the physical wellness program is an
important first step for organizations in developing an overall wellness
agenda. When trying to increase physical wellness program participation,
some employers will offer incentives such as monetary rewards or other
items of value to employees (e.g., gift cards, contributions to health savings
accounts) (Miller, 2012) for employees who are able to participate in well-
ness screenings or meet certain wellness goals. The average value of these
incentives is approximately $460 (Miller, 2012). Other employers might allow
employees a few hours each week away from the office to utilize on-site
wellness facilities, which can allow employees an opportunity to remove
themselves from a stressful work environment. Consistent with motivation
theory, to be effective, the wellness-related reward must be perceived as
valuable to employees (Miller, 2012).
However, when choosing to provide incentives for employees to
participate in wellness programs, employers need to understand that
choosing to only offer rewards to employees who are able to score healthy
on their wellness evaluations might not be the best idea. Some employees
could be working hard to engage in healthy behaviors but have a long ways
to go until they receive a healthy score on their wellness evaluations. If the
frequency of reward is zero for these employees until they receive a healthy
evaluation, they may become quickly discouraged and give up on the healthy
behaviors that they were working hard to adopt. Besides being a poor
motivator to those who are extremely unhealthy, only offering incentives to
those who can pass a wellness evaluation might be found in violation to the
Health Insurance Portability and Accountability Act (HIPAA), in terms of
discriminating against genetically or innately unhealthy individuals. As stated
by Michelle Mello, a professor of law and public health “If the reward is tied
to achieving a health standard but there is no alternative standard available
to people who can’t reasonably be expected to meet that standard, it would
violate HIPAA” (Mello & Rosenthal, 2008, p. 197). Thus, employers need to
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Employee Wellness Program Outcomes 59
understand that there are several laws and regulations pertaining to employee
wellness programs and associated incentives. Before deciding to approve
any type of incentives that are tied to employee wellness, companies should
first understand the relevant legal hurdles such as HIPAA, Americans with
Disabilities Act (ADA), and Genetic Information Nondiscrimination Act
(GINA) (Klein & Pappas, 2009).
Given this, what types of behaviors should employers attempt to reward?
To avoid undue discrimination toward employees, wellness incentives can
be confined to participation. Not only can this help to keep a company free
from legal repercussions but it will also work well to keep employees inter-
ested in healthy behavior. Ultimately, there is no current established “sci-
ence” for wellness program incentive design (Miller, 2008), but employee
behaviors that are commonly rewarded in wellness initiatives across firms
include participating, completing, or enrolling in the wellness program;
achieving goals during or after the program; maintaining specific outcomes;
or recruiting others to participate (Miller, 2008). Ultimately, the reward has to
be valued by employees or it is nonmotivating; however, the days are gone
of giving t-shirts and key chains to encourage employees to participate.
Even though the results of employee wellness programs can vary from
company to company, there are usually some similarities in implementation
among the ones that generate a positive return on investment. Groups such
as the Wellness Council of America (WELCOA) (2007) have developed pro-
cesses for successful employee wellness program implementation based on
their studies of historically successful wellness programs. WELCOA has iden-
tified seven benchmarks for successful employee wellness program imple-
mentation, which are as follows:
1. Capturing CEO support
2. Creating cohesive wellness teams
3. Collecting data to drive health efforts
4. Carefully crafting an operating plan
5. Choosing appropriate interventions
6. Creating a supportive environment
7. Carefully evaluating outcomes
In terms of choosing appropriate interventions, recently offered best
practices in the literature suggest organizations determine their most
pressing health issues in their workforce (e.g., high blood pressure) and
then design wellness interventions and solutions around those issues (Miller,
2012). For example, if a firm’s workforce does not suffer overwhelmingly
from diabetes, then diabetes management interventions are less a priority.
However, gaining management support is probably one of the most
important features of any successful wellness program (Overman, 2009).
Indeed, it is listed as the first benchmark in WELCOA’s seven benchmarks
and can be found in almost all published accounts pertaining to successful
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60 J. S. Swayze and L. A. Burke
implementation. Upper-level management wields the powerful tool of
influence; therefore, they have the ability to make or break the success of
employee wellness programs.
Finally, we contend, as exemplified in this study, that an attribute of
successful wellness program evaluation is the effective use of information
technology to gather, report, and study the effects of the physical wellness
intervention. As illustrated in this case study, wellness kiosks are employee
accessible and require near-zero human manipulation in the organization of
intervention data, because the kiosk hard drive can perform searches on
stored employee data. Such kiosks even generate graphs and visual depic-
tions of program measures, making program metrics easy to digest, utilize,
and incorporate in vital future decision making about wellness initiatives in
the organization. Organizations should therefore carefully investigate and
consider the benefits of using information technology to support and evalu-
ate their wellness programs.
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