Wellness Program Participation and its Association With Reduction in Health Risks and Health Care Costs: One University's Story.

PURPOSE: Evaluate if there is a(n): 1) reduction in health risk behaviors and 2) association between health and wellness initiative participation and claims costs decreases overtime. DESIGN: Health risk behavior change consisted of the analysis of pre (2009) - post (2019) measures of health questionnaire participants. The medical and pharmaceutical claims costs evaluation consisted of a time-series (2016-2019) design with a comparison group. SETTING: A large mid-western university with a health system. SAMPLE: The health risk behavior sample ranged from 5215-5399, depending on the variable of interest. The medical and pharmaceutical costs sample used a cohort of participants (participating all 4 years, n=11114) and non-participants (not participating all 4 years, n=4776). INTERVENTION: Comprehensive employee health and well-being initiative. MEASURES/ANALYSIS: McNemar's tests were used to identify bivariate associations between 2009 and 2019 health risks. The claims cost analysis used propensity score matching based on select demographics and linear mixed-effects regression modeling. RESULTS: Results show statistically significant (P > .001) improvements (ranging from -2.1% to -12.5%) in 7 of 8 health risk behaviors. 2016 and 2019 claims costs have a lower statistically significant (P > .001) percent increase for participants (32.6%) compared to non-participants (47.5%). CONCLUSION: Employers, may consider implementing a comprehensive health and wellness program as part of their strategy to assist in health behavior risk reduction and health care cost containment.

Unique Barriers to Workplace Health Promotion Programs by Wage Category: A Qualitative Assessment of Secondary Data.

PURPOSE: To understand barriers around accessing or using workplace health promotion (WHP) programs among workers in different wage categories. APPROACH: We conducted qualitative analysis of responses to three open-ended questions about WHP program participation, collected as part of an existing WHP program evaluation. Setting: A large mid-western university. PARTICIPANTS: Of the 20,000 employees emailed an online survey, 3,212 responded (16.1%). The sample was mostly female (75%), white (79%), and comprised of staff members (84%). The average age was 44 years and 67% had annual incomes <$75,001. METHOD: We used NVivo-12 Plus and two coders to apply Grounded Theory on the open-ended questions and identify emergent themes. RESULTS: Although most respondents were happy with the program, differences across wage categories emerged around time, financial incentives, commute, workload, and organizational policies/support. Employees at all wage levels were enthusiastic about creating a culture of health but needed different cultural supports to do so. For instance, higher-wage workers needed to overcome self-made time constraints, while lower-wage workers needed supervisor support to overcome coverage constraints that prevented participation. CONCLUSION: The unique participation challenges experienced by employees in different wage categories provide justification for WHP programs that can better accommodate the participation barriers of all employees. While some programs may simply require more flexible offerings, supervisors may need to be trained to support and foster healthy environments.

Supporting Employee Health at Work: How Perceptions Differ Across Wage Category.

PURPOSE: This study examines the association between sources of stress and perceptions of organizational and supervisor support for health and well-being. DESIGN: Retrospective, cross-sectional analysis. SETTING: Large university in the mid-western United States. SAMPLE: This study focused on university employees with complete data for all variables (organizational support/N = 19,536; supervisor support/N = 20,287). MEASURES: 2019 socioeconomic and demographic characteristics, count of chronic conditions, sources of stress and perceptions of organizational and supervisor support. ANALYSIS: For the multivariate analyzes, linear regression models were analyzed separately by wage bands (low ≤$46,100; middle >$46,100-$62,800; high >$62,800). RESULTS: For all employees, workplace stressors, including problematic relationships at work and heavy job responsibilities, were negatively associated with perceptions of supervisor and organizational support. In comparison, the most salient home-based stressors were negatively associated with perceptions of supervisor support for the lowest-wage band (the death of a loved one, b = -0.13) and middle-wage band (personal illness or injury, b = -0.09), while the one for the highest-wage band (illness or injury of a loved one, b = 0.07) was positively associated with perceptions of supervisor support. CONCLUSION: Stressful job responsibilities and work relationships are associated with lower perceptions of supervisor and organizational support for health and well-being across all wage bands. Favorable perceived support for personal stressors only among high wage earning employees may suggest a need for improved equity of perceived support for these stressors among lower wage workers.