Not every program is.
Have you seen recent headlines by respected news organizations suggesting wellness programs don’t work? Sensational headlines grab attention, but it’s important to look behind the headlines, even if they’re from prominent news agencies citing respected scientific journals. The New York Times recently reported “Employee Wellness Programs Yield Little Benefit, Study Shows” based on its interpretation of a study published in the Journal of the American Medical Association (JAMA).
The program evaluation, design and statistical analysis were of excellent quality. The design of the wellness program, however, didn’t align with many evidence-based best practices. Fundamentally, the wellness program had a series of transactional components for modest gift card incentives, including completion of health assessment and biometric screening, structured webinar modules and wellness challenges. Rather than representing a holistic approach to identifying individual needs and offering tailored support, much of this approach was premised on educating employees on what they should do. Yet, research shows that education alone doesn’t result in behavior change. Behavior design science tells us that a flexible, personalized approach addressing individual interests, readiness to change, preparation to meet obstacles, and learning preferences (e.g., telephonic coaching, online coaching, chat with coach, and mobile apps) is key to supporting successful behavior change.
As well, a relatively small percentage of the eligible workforce (24%) participated in an average of 1.3 learning modules (of 8 available) over 4-7 weeks, which would be considered a very low dose of intervention. To use a medical analogy, would we expect patients to get the full benefit of a medication if they took only a partial dose?
Cultural support — including visible support from leaders, front-line managers and grass roots wellness champions — has also been shown to be a key best practice for successful wellness initiatives. These culture of health and wellness supports weren’t reported for this program.
Behavior change and resulting improvements in health and healthcare costs take time. The time horizon for measurable health improvements and healthcare cost avoidance generally ranges from two to five years. A study of 18 months truly wouldn’t be expected to demonstrate substantial health and financial outcomes. Though while not statistically significant, this study reported better healthcare cost experience for participants compared to non-participants.
It’s important to note that we can’t draw definitive conclusions or causal relationships from any one study. In addition to looking behind the headlines at the details of the program and study design, we should consider the full body of evidence to determine if wellness programs can work. The Health Enhancement Research Organization (HERO) offers some considerations for assessing the evidence on “what works” for health and wellness initiatives.
So, was this “wellness program” really designed to succeed?
Perhaps more than anything else, reports like this underscore that all wellness programs are not the same. By lumping all together under the same label, too may assumptions can be made about how the wellness initiative was designed and executed. Better questions to ask are, how many evidence-based best practices were used to design the initiative, and how well were they executed? The HERO Health & Well-being Best Practices Scorecard in Collaboration with Mercer© is a free survey that outlines best practices and provides a score for your organization and national benchmarks for comparison. Using the HERO Scorecard will help you answer the question — Is your wellness program designed to succeed?