Importance Employers have increasingly invested in workplace wellness programs to improve employee health and decrease health care costs. However, there is little experimental evidence on the effects of these programs. Objective To evaluate a multicomponent workplace wellness program resembling programs offered by US employers. Design, Setting, and Participants This clustered randomized trial was implemented at 160 worksites from January 2015 through June 2016. Administrative claims and employment data were gathered continuously through June 30, 2016; data from surveys and biometrics were collected from July 1, 2016, through August 31, 2016. Interventions There were 20 randomly selected treatment worksites (4037 employees) and 140 randomly selected control worksites (28 937 employees, including 20 primary control worksites [4106 employees]). Control worksites received no wellness programming. The program comprised 8 modules focused on nutrition, physical activity, stress reduction, and related topics implemented by registered dietitians at the treatment worksites. Main Outcomes and Measures Four outcome domains were assessed. Self-reported health and behaviors via surveys (29 outcomes) and clinical measures of health via screenings (10 outcomes) were compared among 20 intervention and 20 primary control sites; health care spending and utilization (38 outcomes) and employment outcomes (3 outcomes) from administrative data were compared among 20 intervention and 140 control sites. Results Among 32 974 employees (mean [SD] age, 38.6 [15.2] years; 15 272 [45.9%] women), the mean participation rate in surveys and screenings at intervention sites was 36.2% to 44.6% (n = 4037 employees) and at primary control sites was 34.4% to 43.0% (n = 4106 employees) (mean of 1.3 program modules completed). After 18 months, the rates for 2 self-reported outcomes were higher in the intervention group than in the control group: for engaging in regular exercise (69.8% vs 61.9%; adjusted difference, 8.3 percentage points [95% CI, 3.9-12.8]; adjustedP = .03) and for actively managing weight (69.2% vs 54.7%; adjusted difference, 13.6 percentage points [95% CI, 7.1-20.2]; adjustedP = .02). The program had no significant effects on other prespecified outcomes: 27 self-reported health outcomes and behaviors (including self-reported health, sleep quality, and food choices), 10 clinical markers of health (including cholesterol, blood pressure, and body mass index), 38 medical and pharmaceutical spending and utilization measures, and 3 employment outcomes (absenteeism, job tenure, and job performance). Conclusions and Relevance Among employees of a large US warehouse retail company, a workplace wellness program resulted in significantly greater rates of some positive self-reported health behaviors among those exposed compared with employees who were not exposed, but there were no significant differences in clinical measures of health, health care spending and utilization, and employment outcomes after 18 months. Although limited by incomplete data on some outcomes, these findings may temper expectations about the financial return on investment that wellness programs can deliver in the short term. Trial Registration ClinicalTrials.gov Identifier:NCT03167658

/pdf/effect-of-a-workplace-wellness-program-on-employee-health-l15349fm56.pdf

Effect of a Workplace Wellness Program on Employee Health and Economic Outcomes: A Randomized Clinical Trial.

Investing in non-communicable disease prevention and management to advance the Sustainable Development Goals

Background: The evidence surrounding the value of workplace health promotion in positively influencing employees’ health and wellbeing via changes to their health behaviours is growing. The aim of the study was to explore employers’ views on the promotion of workplace health and wellbeing and the factors affecting these views. Methods: Using a qualitative phenomenological approach, 10 focus groups were conducted with employers selected from a range of industries and geographical locations within Western Australia. The total sample size was 79. Results: Three factors were identified: employers’ conceptualization of workplace health and wellbeing; employers’ descriptions of (un)healthy workers and perceptions surrounding the importance of healthy workers; and employers’ beliefs around the role the workplace should play in influencing health. Conclusions: Progress may be viable in promoting health and wellbeing if a multifaceted approach is employed taking into account the complex factors influencing employers’ views. This could include an education campaign providing information about what constitutes health and wellbeing beyond the scope of occupational health and safety paradigms along with information on the benefits of workplace health and wellbeing aligned with perceptions relating to healthy and unhealthy workers.

/pdf/employers-views-on-the-promotion-of-workplace-health-and-4ce7esg9mg.pdf

Employers’ views on the promotion of workplace health and wellbeing: a qualitative study

Given the complex demands of many workplaces, there is growing interest in the potential beneficial effects of mindfulness-based programs (MBPs) for employees. This meta-analysis systematically synthesizes the results of randomized controlled studies conducted in various workplace settings. Eligible studies were identified by a systematic literature search in four electronic databases and complementary manual search strategies through 11/2018. Random-effects models were used to synthesize data across 56 studies including n = 2689 participants and n = 2472 controls. The validity of synthesized effect size estimates was analyzed for heterogeneity and influential cases (outliers). Risk of bias was assessed following Cochrane recommendations. Analyses of between-group effects indicated that MBPs effectively reduce stress, burnout, mental distress, and somatic complaints, while improving mindfulness, well-being, compassion, and job satisfaction—all with small to large effect sizes ranging from Hedge’s g = 0.32 to 0.77. Results were maintained in follow-up assessments ≤ 12 weeks. Heterogeneity among primary studies was not explained consistently by program or participant characteristics in the exploratory moderator analyses. Results on work engagement and productivity were limited by low numbers of primary studies with outliers among their effect sizes. Our meta-analysis provides evidence that MBPs effectively promote the health and well-being of employees in various occupational settings. Further research is needed to investigate potential benefits on work-related outcomes and effects for longer-term follow-ups.

/pdf/mindfulness-based-programs-in-the-workplace-a-meta-analysis-2vz4l4u14k.pdf

Mindfulness-Based Programs in the Workplace: a Meta-Analysis of Randomized Controlled Trials

https://escholarship.org/content/qt38376530/qt38376530.pdf?t=qaurah

Ten questions concerning well-being in the built environment

Objective: To respond to the question, “Do workplace health promotion programs work?” Methods: A compilation of the evidence on workplace programs’ effectiveness coupled with recommendations for critical review of outcome studies. Also, reviewed are recent studies questioning the value of workplace programs. Results: Evidence accumulated over the past three decades shows that well-designed and well-executed programs that are founded on evidence-based principles can achieve positive health and financial outcomes. Conclusions: Employers seeking a program that “works” are urged to consider their goals and whether they have an organizational culture that can facilitate success. Employers who choose to adopt a health promotion program should use best and promising practices to maximize the likelihood of achieving positive results.

Do Workplace Health Promotion (Wellness) Programs Work

wo global pandemics—SARS-CoV2 infection and obesity—recently intersected; this convergence exac-erbated the virus’ most harmful effects 1 and dispro-portionately affected underserved communities. 2,3 To a large extent, the underlying health conditions—reported by the US Centers for Disease Control and Prevention (CDC)—that heightened vulnerability to the virus are lifestyle-related and directly impacted by social determinants of health (SDoH) that, all too often, prevent the healthy choice from being the easy choice. 4 These unhealthy lifestyle behaviors increasingly affect healthcare expenditure, driving as much as 90% of healthcare dollars spent. 5 This has made the precepts of lifestyle medicine (LM) more relevant and more urgently needed than ever. 6 LM, as defined by the American College of Lifestyle Medicine (ACLM), is the use of evidence-based, lifestyle, therapeutic intervention—including a whole-food, plant-predominant eating pattern, regular physical activity, restor-ative sleep, stress management, avoidance of risky substances, and positive social connection—as a primary modality, delivered by clinicians trained in these modalities

Making the Case for Lifestyle Medicine.

Optimizing Health and Well-Being: The Interplay Between Lifestyle Medicine and Social Determinants of Health.

The time is NOW for Lifestyle Medicine. In this review based on a presentation at the American College of Lifestyle Medicine (ACLM) 2021 annual conference, ACLM Current President Cate Collings, MD, Immediate Past-President Dexter Shurney, MD, and President Elect Beth Frates, MD, share insights on the current state of lifestyle medicine (LM). Interest in LM has greatly advanced in the face of disruptions from the COVID-19 pandemic, expanded educational opportunities in the field, and a rapidly changing healthcare landscape. With growing access to virtual care, advancing technologies, growing emphasis on home-based chronic care, continuing corporate healthcare mergers and acquisitions, and widening adoption of personalized, patient-empowered treatments, the time is ripe for LM interventions to move to the mainstream. As health investments and costs skyrocket, and new players enter the scene, traditional models of payments, reimbursements, and incentives are slowly being upended. Companies and healthcare systems are finally recognizing the scientific evidence and powerful but undervalued potential of LM to accelerate healthy outcomes while controlling costs. Taken together, the lessons from the COVID-19 pandemic, the growth in LM educational opportunities, and the evolving “business of medicine landscape” signal that the time for lifestyle medicine is NOW.

The Time is Now For Lifestyle Medicine: Lesson From Lifestyle Medicine Leaders

of chunking can be found. In: Boser U, ed. Learn Better. New York, NY: Penguin Random House LLC; 2017. 21. Barkley EF, Major CH. Interactive Lecturing: A Handbook for College Faculty. Hoboken, NJ: John Wiley & Sons, Inc.; 2018. 22. Mar RA, Li J, Nguyen ATP, Ta CP. Memory and comprehension of narrative versus expository texts: a meta-analysis.Psychon Bull Rev. 2021;28(3):732-749. doi:10.3758/s13423-020-01853-1. 23. Nutbeam D, Lloyd JE. Understanding and responding to health literacy as a social determinant of health. Annu Rev Public Health. 2021;42:159-173. doi:10.1146/annurev-publhealth090419-102529. 24. Eysenbach G. Infodemiology and infoveillance: framework for an emerging set of public health informatics methods to analyze search, communication and publication behavior on the internet. J Med Internet Res. 2009;11(1):e11. doi:10.2196/jmir.1157.

Dexter Shurney

Papers

Do Workplace Health Promotion (Wellness) Programs Work

Making the Case for Lifestyle Medicine.

Optimizing Health and Well-Being: The Interplay Between Lifestyle Medicine and Social Determinants of Health.

The Time is Now For Lifestyle Medicine: Lesson From Lifestyle Medicine Leaders

The Role of Employers as Guardians Against the Growing Assault on Truth