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

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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

Objective This study aimed to examine a detailed breakdown of costs (absenteeism, presenteeism, and medical/pharmaceutical expenses), of the employees in four pharmaceutical companies in Japan. Methods This is a cross-sectional study. Absenteeism and presenteeism were measured by a self-administered questionnaire for workers, and their costs were estimated using the human capital approach. Presenteeism was evaluated by the degree affected quality and quantity of work. Medical and pharmaceutical expenses were obtained by insurance claims. Results The monetary value due to absenteeism was $520 per person per year (11%), that of presenteeism was $3055 (64%), and medical/pharmaceutical expenses were $1165 (25%). Two of the highest total cost burdens from chronic illness were related to mental (behavioral) health conditions and musculoskeletal disorders. Conclusion A total cost approach can help employers set priorities for occupational health, safety, and population health management initiatives.

Total Health-Related Costs Due to Absenteeism, Presenteeism, and Medical and Pharmaceutical Expenses in Japanese Employers.

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.

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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.

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

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

Objective: Determine whether there is a relationship between level of engagement in workplace wellness programs and population/individual health risk reductions. Methods: A total of 7804 employees from 15 employers completed health risk appraisal and laboratory testing at baseline and again after 2 years of participating in their personalized prevention plan. Population and individual health risk transitions were analyzed across the population, as well as by stage of engagement. Results: Of those individuals who started in a high risk category at baseline, 46% moved down to medium risk and 19% moved down to low risk category after 2 years on their prevention plan. In the group that only engaged through the Web-based technology, 24% reduced their health risks (P < 0.0001).Conclusions: Engaging technology and interactive Web-based tools can empower individuals to be more proactive about their health and reduce their health risks. C hronic illness and health care costs are advancing at a staggering rate worldwide. The World Economic Forum, in its Global Risk 2010 report, indicated that the impact on developing countries as well as advanced economies from the “silent pandemic” of chronic illnesses (like diabetes, heart disease, and cancer) is a critical global risk that is destructive and debilitating to individuals as well as nations and that the only sustainable solution is a greater emphasis on prevention. These dramatic increases are largely attributable to lifestyle- or behavior-related causes such as unhealthy eating habits, smoking, or sedentary lifestyles. Given the converging epidemiological, political, cultural, and financial trends, driving accountable care organizations and patient-centered medical home initiatives is the need for better health at lower cost. This requires a sustainable prevention strategy in concert with effective population health management interventions to reduce the growing burden of health risks leading to the expanding burden of chronic illness as not only a fiscal imperative but also a clinical and moral imperative. 1–3 The current sick care model in the United States is not designed to meet the real health and wellness needs of people. Therefore, employers fund the majority of the economic burden of this broken system, because they pay for the ever increasing costs of medical care while our system spends less than $0.05 of every health care $1.00 on prevention to help promote a healthier, safer, more productive workforce. A large percentage of 137 million employees in the United States receive health benefits at work; therefore, employers have a unique opportunity to play a stronger role because lifestyle risks and medical conditions directly influence productivity. Workplace health and wellness initiatives now reach millions of workers, with occupational health professionals designing and delivering wellness and prevention services typically impacting em

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The association of technology in a workplace wellness program with health risk factor reduction.

In recent years, new products have entered the marketplace that complicate decisions about tobacco control policies and prevention in the workplace. These products, called electronic cigarettes (e-cigarettes) or electronic nicotine delivery systems, most often deliver nicotine as an aerosol for inhalation, without combustion of tobacco. This new mode of nicotine delivery raises several questions about the safety of the product for the user, the effects of secondhand exposure, how the public use of these products should be handled within tobacco-free and smoke-free air policies, and how their use affects tobacco cessation programs, wellness incentives, and other initiatives to prevent and control tobacco use. In this article, we provide a background on e-cigarettes and then outline key policy recommendations for employers on how the use of these new devices should be managed within worksite tobacco prevention programs and control policies.

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Guidance to Employers on Integrating E-Cigarettes/Electronic Nicotine Delivery Systems Into Tobacco Worksite Policy

Author(s): Goetzel, Ron Z; Parker, Edith; Terry, Paul E; Pasick, Rena J; Burton, Wayne N; Green, Larry; Hunnicutt, David; Palma-Davis, LaVaughn; Eng, Eugenia; Schulz, Amy J; Minkler, Meredith; Anderson, David R; Strecher, Victor J; Katz, David; Serxner, Seth; Whitsel, Laurie; Pronk, Nicolaas P; Wallerstein, Nina; Loeppke, Ron; Resnicow, Ken; Linnan, Laura; Israel, Barbara

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Ron Loeppke

Papers

Do Workplace Health Promotion (Wellness) Programs Work

The association of technology in a workplace wellness program with health risk factor reduction.

Guidance to Employers on Integrating E-Cigarettes/Electronic Nicotine Delivery Systems Into Tobacco Worksite Policy

Twenty-Two Health Promotion Pioneers