Contrary to the many benefits of worksite wellness programs, most employers have yet to embrace the worksite wellness strategy according to the findings of the 2004 National Worksite Health Promotion Survey.
Only 6.9 percent of surveyed organizations met the criteria for a comprehensive health promotion program. This is far short of the 75 percent target included in the Healthy People 2010 goal which shows that there are still significant barriers to the large-scale adoption of worksite health promotion practices by organizations, both large and small.
The encouraging news is that since the 2004 report was published, there appears to be more momentum toward implementation of comprehensive work site health promotion. This is evident by pending federal legislation and the growth of employer-based health coalitions such as the National Business Group on Health, Institute for Health and Productivity Management, Center for Health Value Innovation, and the National Business Coalition on Health. Peer-based executive advocacy through the Leading by Example initiative of Partnership for Prevention is another example of this trend towards comprehensive workplace health promotion.
Low participation rates by employees could significantly limit the potential benefits of participating in workplace wellness programs, as could systematic differences between participants and non-participants. Research performed by Gallup indicated that out of the 60% of employees who were aware of their company offered a wellness program only 40% participated.
A 2008 study from the University of Minnesota provided insight into the likelihood of employee participation in an exercise promotion program. Their findings illustrate barriers to program participation that may be applicable to other types of programs and workplace settings. Employees were offered a financial incentive to attend a designated set of fitness facilities at least 8 times per month during the study period, and researchers administered a survey to over 3,000 program participants and non-participants to better understand their decision to participate. The research team included survey questions to assess each employee's attitudes and practices related to fitness prior to the program being offered, their marginal utility related to the financial incentive offered, the marginal cost of exercising (based on the cost of time and the financial cost of fitness center membership), prior history of chronic disease, and demographic characteristics related to age, gender, race and ethnicity, income, and employment type within the university system. Based on these survey responses, researchers reported the marginal effects related to the probability of 1) signing up for the program and 2) meeting program participation criteria by exercising 8 times per month to receive the financial incentive.
Employees with a higher time cost of exercise, calculated by the campus where the employee worked and by the number of participating fitness sites in the employee's home zip code, had a lower probability of signing up for and completing the program. Younger workers (ages 18–34)were more likely to sign up for the program relative to older employees, and women were more likely to sign up for the program than men. Researchers also found that employees with diabetes or low back pain were less likely to participate.
Program participation reflects a different trend. When researchers investigated the likelihood that an individual would be a regular program exerciser, defined as a participant in the program who checked in at a participating facility at least 8 times per month, for at least 50% of the time period for which the financial incentive was offered. Program participation in this sense means that an employee both signed up and completed the criteria to receive the reward. Regular exercise were more likely to be older (ages 55+), male, and to be classified as regular exercisers before the program was offered. These findings suggest that there may be differences between employees who would like to, or intend to, participate in certain workplace programs, and those who are likely to be able to participate and benefit. While this study focuses specifically on exercise and participation, lessons regarding the time cost of participation, location barriers to participation, and age and gender differences in participation rates are all important considerations for a firm interested in designing an effective workplace wellness program, especially if the goal is to promote a new behavior.
Ongoing management support and accountability are critical to successful worksite health promotion programs. Per research performed by Gallup, "Managers are uniquely positioned to ensure that each of their employees knows about the company's wellness program and to encourage team members to take part." By engaging workers in this organizational culture, employees become 28% more likely to participate in wellness programs than the average employee. Methods in which leaders can overcome the barrier of engagement is to not only model behaviors of the program but to consistently and effectively communicate the value of the wellness programs to employees. By creating the time and focus to improve the overall health and wellness of employees, managers can present many health and costs benefits to all members of the organization.