Do worksite wellness programs really work?

Worksite wellness programs have become somewhat of a staple in most businesses in the United States, as wellness has ballooned to a nearly $8 billion industry. According to the Kaiser Family Foundation’s annual survey, 53% of small firms and 82% of large firms now offer a program in at least one of the areas of smoking cessation, weight management, and behavioral or lifestyle change.  But what is the effect of a multicomponent workplace wellness program on health and economic outcomes?  A study recently published in the Journal of the American Medical Association (JAMA), which is the first peer-reviewed, large-scale, multi-site randomized trial on the topic, sought to answer that question.

Researchers from the University of Chicago and Harvard partnered with BJ’s Wholesale Club to facilitate the study across their 160 locations. The researchers designed the study in such a way that they were able to address many limitations of previous studies, such as failing to have a comparison group and determining whether participants in wellness programs are already healthier or more motivated that those who don’t participate.

The researchers randomly-assigned 20 BJ’s Wholesale Club outlets to offer a wellness program for 18 months to the 4,037 employees at those intervention worksites, then compared their outcomes with those of the 28,937 employees at the other 140 randomly-assigned control worksites. While the control worksites received no wellness programming, the intervention worksites offered a program that was comprised of eight modules focused on nutrition, physical activity, stress reduction, and other related topics. The modules were facilitated by registered dieticians.

When looking at the results of the study, four outcome domains were assessed:

1. Self-reported health and behaviors via survey (29 outcomes)

• Included physical activity, nutrition, mental health, sleep quality, weight management, and others.

2. Clinical measures of health via screenings (10 outcomes)

• Included cholesterol and glucose levels, blood pressure, body mass index (BMI), and obesity.

3. Health care spending and utilization (38 outcomes)

• Included medical spending and utilization (hospitalizations, ED visits, urgent care visits), pharmaceutical spending and utilization, and others.

4. Employment outcomes via administrative data (3 outcomes)

• Included absenteeism, tenure, and job performance.

The rates for engaging in regular physical activity and for actively managing weight were both higher in the intervention group than in the control group (69.8% vs 61.9% and 69.2% vs 54.7%, respectively), but there were no other significant differences in the other pre-specified outcomes.

Are we saying that employers should stop offering wellness programs?  No.  However, it would be wise to carefully decide how dollars are spent, as the financial return on investment has not been proven. Some wellness vendors, for example, sell annual health risk assessments that go far beyond the recommendations of the United States Preventive Services Task Force and have not been shown to be cost-effective. A well-designed worksite wellness program that is focused on supporting employees in making healthy behaviors can still be beneficial.  This can be accomplished by doing things like providing real food instead of processed food, offering coverage for tobacco cessation resources and evidence-based programs like the Diabetes Prevention Program, and encouraging employees to be active throughout the day by putting policies in place that support them in doing so – and that’s just for the physical component of health.  It’s also important to offer ways to encourage better mental, financial, and social health, which can often be done at low or no cost.

For more thoughts and ideas, please contact us!