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Implementation of Health and Wellness Programs The Pennsylvania State University Leigha Anderson, Mara Scaliti, Natalie Hubert, Andrea StrawnAbstract An underrated section to an employee’s benefits package are health and wellness programs. Health and wellness programs can be large or small investments for companies, but they can potentially reap sizeable rewards. Company health and wellness plans greatly impact an organization’s success by employing healthy, productive, and satisfied individuals. This study is exploratory research about the effect wellness programs have on job satisfaction levels, job performance, and employee absences. Through a short survey, this exploratory research effectively supports the hypotheses. The results are that job satisfaction is greater in employees who use the health and wellness opportunities, job performance is higher for those employees who use the health and wellness opportunities, and absences are lower in those employees using more of the health and wellness program. This research is exploratory and involves limitations and implications that are further discussed in the following report.Introduction In the last thirty years, health and wellness programs across the United States have become extremely popular in small and large businesses. Wellness programs are defined as “a program that promotes healthy activity or an organization-wide policy designed to support healthy behavior and improve health outcomes at work. These programs consist of activities such as health education, coaching seminars, weight management programs, medical screenings, on-site fitness programs, and more” (). According to an article by Aaron Toja and Vincent Ling, employee wellness programs are a flourishing concept. In their article “Wellness Programs”, Toja and Ling stated, “Wellness programs are not new. The automobile-manufacturing luminary Henry Ford was said to have created ‘a team of 150 investigators who visited employees' homes and asked them about drinking, gambling, diet, savings, and other personal matters, and those who did not meet Ford's standards within six months were fired’” (Toja & Ling). Current wellness programs greatly differ than they did in the early 1900’s. According to Toja and Ling in the Journal of American College of Radiology,“Modern worksite wellness programs began in the 1970s as a component of the worksite health promotion movement. The movement was fueled by the national cultural trend toward fitness, the medical profession's acknowledgment that wellness programs affect health outcomes, and employers' desire to reduce costs. The programs gained traction in the 1980s as the fitness culture progressed and research on the topic strengthened” (Toja & Ling).Employee wellness programs gained popularity in 2010 when the Patient Protection and Affordable Care Act became a law. According to the book; Employee Assistance Programs: Wellness and Enhancement Programs and research conducted by the Center for Disease Control and Prevention, “Health care costs are projected to outpace gross domestic product growth and reach 20% of the gross domestic product by 2020.” Employers pay for approximately one-third of these rising healthcare costs. Moreover, studies have demonstrated that more than $300 billion could be saved each year if preventable diseases were eradicated ().”Not only are wellness programs gaining popularity from employees, but they are also saving companies money on health care costs. According to , “A 2011 study published by the American Journal of Health Promotion demonstrated that health care costs rose at a 15 percent slower rate among wellness program participants when employers consistently offered a wellness program to their employees”. This statistics proves that wellness programs help to decrease insurance costs. Another reason why wellness programs can help the current issues in the United States is because it is helping to fight obesity. In another study by the CDC in 2009, “The medical care costs of people with chronic diseases accounted for more than 75% of the nation's $2.2 trillion medical care costs in 2009” (). In another study by the CDC, “researchers looked at data from 37,626 employees in Washington State and found that the overall incidence of obesity among workers was 24.6%. They also noted that percentages varied by job type. For instance, only 11.6% of those in health-diagnosing occupations, for example doctors, dentists, and veterinarians, were obese. On the other hand, 38.6% of truck drivers, who spend most of their days sitting, were obese” (). The importance of this study exemplifies how important it is to incorporate exercise into the daily workday, and to make sure employees are having access to all aspects of a wellness program. There are many benefits to wellness programs such as decreasing obesity, increasing productivity, decreasing absenteeism, and decreasing insurance costs. These positive aspects lead to the conclusion that wellness programs are a successful benefit for organizations. An important research statistic from Aflac (a voluntary insurance company) found large differences between companies that offer wellness programs and companies that do not offer wellness programs. According to the study, employees who did not work for a company with a wellness program were only 53% satisfied with their job compared to 66% of employees who worked for a company with a wellness program . At companies with wellness programs, 59% of employees completely or strongly agree their company has a reputation as a great place to work, compared to 43% of employees who work at a company without a wellness program. These statistics exemplify that employees are more satisfied with the companies in which they are employed that have wellness programs, compared to employees whose places of work do not.The objective of this exploratory study is to gain knowledge about wellness programs. Our research group plans to work in Human Resources (HR) after college, and researching wellness programs is beneficial for future success in our careers. As future HR professionals, our job may potentially include managing and monitoring the benefits programs at our organizations. Having base information and researching health and wellness programs will help our careers because we will be able to understand the positive influences these programs have on motivating employees. Overall, HR’s job is to ensure employees’ happiness and job satisfaction, and studying health and wellness programs will allow our group to do so in our future careers. Theory and HypothesesOur group believes that a company could be greatly impacted by health and wellness programs. We are interested in looking at how these programs would affect job satisfaction, productivity, and absenteeism. In the study done by Holzbach, Piserchia, McFadden, Hartwell, Herrmann, and Fielding they focused on a two year long study that was conducted to evaluate how a health promotion program affected the work-related attitudes of the employees within organizations. The researchers believe that “a key business issue for most employers today is maximizing productivity and competitiveness” (Holzbach PhD, Piserchia MS, McFadden MBA, Hartwell PhD, Herrmann MD & Fielding MD) and therefore, reached the hypothesis that using health and wellness could control benefit cost. The study used the process of quasi-experimental with nonequivalent control groups used to evaluate the programs. The study program offered multiple options including health screenings, lifestyle improvement programs, seminars, and environmental improvements. Upon assessing the data that was collected within the study, the researchers found that the employees attitudes whose companies participated in the health and wellness program were significantly greater and more favorable than those employees whose companies did not participate in the health and wellness programs. They also found that the programs had a positive effect on exercise and overall physical fitness including decline in smoking, reduction in absenteeism, and reduction of health benefit cost as well as, utilization of services. We found this as an interesting study because we had a similar hypothesis that health and wellness programs were beneficial to employees which would result in being beneficial to the company they were employed at as well. The researchers also found that significant changes were found on employees attitude toward organizational commitment, their working conditions, job competence, job security, supervision, and both pay and fringe benefits. These finding were promising to us because they furthered our belief in our hypothesis of health and wellness programs being beneficial to a company for improvement to employee morale, turnover rates, and satisfaction and helped to support it along with our findings in our own research.A recent business case study conducted by Sameer Kumar and Michael McCalla, explored the operational impact of employee wellness programs. According to the case study posted in the International Journal of Productivity and Performance Management, “The purpose of this case study to investigate the effectiveness of employee wellness programs on employee engagement and the reduction of employee health care costs. The intent of the analysis is to explain the typical costs associated with these programs and the potential benefits to the employer and employee” (Kumar & McCalla). Kumar and McCalla investigated similarly to our group. They also conducted an anonymous electronic survey to a private business. The survey wanted to evaluate productivity and satisfaction amongst workers who are currently enrolled in their employee wellness programs. Kumar and McCalla investigated the following questions: “Does the cost of employee wellness programs reduce the cost of employee benefit programs over time? What are the necessary components of an effective employee wellness program? What strategies can a company use if it does not have the financial resources to support an effective wellness program? What can a company leverage (employee rewards, penalties, access to health care providers) to ensure its wellness program is effective?” (Kumar and McCalla). Through the researchers electronic survey, they found that wellness programs reduce the cost of employee benefit programs over time, and suggested ways to improve and create a strategic wellness program in large and small companies alike. According to business case study, “The most successful companies are using data from their employee wellness programs in their health cost analysis. Those who have done so have seen their health care costs decrease. It is authors' assertion, a reasonable annual cost for an employee wellness program per employee would be as much as 20 per cent of the individual health care plan. This cost, $1,000 per employee, is expected to have positive return on investment” (Kumar and McCalla). Ron Goetzel and Ronald Ozminkowski from the Department of Health and Productivity Research at Thompson Healthcare wrote about the ‘The Health and Cost Benefits of Work Site Health-Promotion Programs’. In terms of our research question (determining if the benefits outweigh the costs of incorporating wellness programs into organizations), this source is in agreement that wellness programs are in fact beneficial. A Work Site Health-Promotion Program (WHP) is also sometimes called an Employee Wellness Program. The study reviews the most recent of findings in Work Site Health-Promotion, focusing on factors that influence the health and productivity of workers. The study starts off by defining WHP and reviewing the literature that addresses its’ business rationale. It then lists the objections and barriers that may prevent sufficient investment in a WHP. They describe the characteristics of effective programs including their ability to assess the need for services, attract participants, use behavioral theory as a foundation, incorporate multiple ways to reach people, and make efforts to measure program impact. Promising practices are noted which included the senior managements support and participation in these programs. The challenge of achieving widespread dissemination of information regarding success factors is due to the fact that only about 7% of employers use all the program components required for successful interventions. The methods they use through Work Site Health-Promotion Programs go more in depth when compared to our method. They focused on three aspects; primary, secondary, and tertiary prevention efforts. Examples of primary prevention include; “programs that encourage exercise and fitness, healthy eating, weight management, stress management, use of safety belts in cars, moderate alcohol consumption, recommended adult immunizations, and safe sex” (Goetzel R., Ozminkowski R.; 2008) The secondary prevention considers those who are already at a high risk for developing health issues due to lifestyle choices. Examples of secondary prevention includes; “hypertension screenings and management programs, smoking cessation telephone quitlines, weight loss classes, and reduction or elimination of financial barriers to obtaining prescribed lipid-lowering medications.” (Goetzel & Ozminkowski ) Individuals who have developed a type of disease beyond their control, fall under the tertiary prevention (disease management). Examples of this include; the “promotion of better compliance with medications and adherence to evidence-based clinical practice guidelines for outpatient treatment” (Goetzel & Ozminkowski). Their hypothesis is that “if a WHP is properly designed, it can increase employees' health and productivity.” Through these case studies and research, our group has deciphered that there are more positives than negatives to wellness programs, and they are essential in creative productive and satisfied employees. In conclusion to the past research conducted on health and wellness programs, our group chose to develop and explore three hypotheses:Hypothesis 1: The more an employee uses the health and wellness program, the higher their job performance will be.Hypothesis 2: The more an employee uses the health and wellness program, the higher the job satisfaction will be.Hypothesis 3: The more an employee uses the health and wellness program, the lower the absentee rate will be.Method Our group decided to use an electronic survey method, Qualtrics to help us analyze and collect data. An online survey was the most realistic collection method for our group to use. It was simple to send an email to the company supervisor and have her pass on the Qualtrics link. Qualtrics continuously saves all the data for our group and once it was collected, it was downloadable to Microsoft Excel for data analysis. The research design of our project was within-case. This research design helped our group better understand how our independent variable - the use of the health and wellness program, affects our dependent variables - job performance, job satisfaction, and absenteeism. Our group used a personal connection with a private insurance company called Johnson, Kendall and Johnson (JKJ) in Newtown, Pennsylvania that utilizes an employee wellness program. After creating an eleven question survey, we distributed it by email via a listserv to all employees at JKJ. The survey was anonymous, and any employees who participated were made aware of this. Our group did not select any of the respondents, but instead made the survey optional and available to all employees. Overall, 60 employees responded. Our group worked closely with the JKJ President and Wellness Executives to form the most successful survey that would analyze employee’s performance, satisfaction, and absenteeism. Since the JKJ Wellness directors have created surveys similar to ours, we utilized many of their previous questions. These were used as our established measures. The survey consisted of a variety of different types of questions. It began with easy-to-answer administrative questions; which asked what department and position they worked in and the amount of years they have been employed at Johnson, Kendall & Johnson. Those were followed by five target questions that we grouped together. The questions inquired what wellness services the employee consistently uses, their feelings towards JKJ’s Wellness Program, amount of days they have been absent in the past year, and their current level of job performance and job satisfaction. Continuing the item sequence, the following questions were two classification/personal questions asking the employees age and gender. The survey concluded with two, target, open-ended questions, which asked their favorite aspect of JKJ’s Wellness Program and suggestions they have for the company to improve the program. Five of the target questions were either scales, established measures, or both. Question (3) asked “Which wellness services do you consistently use? Please select all that apply”; we used a Category Scale because it gave the employees alternatives and the ability to choose more than one option. Question (4) “Please select which option describes your feelings towards JKJ's Wellness Program”; we used an established measure and a Likert Scale for the employees to determine their degree of agreement for the wellness program. Question (5) “How many days have you been absent from your job for the following reasons in the past year”; we used an established measure to determine the reason why and how often they may have been absent. Questions (6) “Please evaluate your own current level of job performance in each of the following areas”; we used an established measure and an Itemized Rating Scale to determine what their performance rating was for their abilities in different areas. Questions (7) “Please evaluate your own current level of job satisfaction in each of the following areas”; we used an established measure and Likert Scale to rate their satisfaction in working for the company. Regression is the statistical procedure we used in order to test our hypotheses. We chose to use regression due to the results from our survey. Regression analysis focuses on existing relationships and the strength of those relationships. Regression analyses indicate whether the independent variable has a significant relationship with the dependent variables. In our research study we focus on the relationship health and wellness program use has on job performance, job satisfaction, and absenteeism amount. Originally, our plan was to compare two groups of people; those who participate in the wellness program as opposed to those who do not. Instead, the survey resulted in every participant utilizing the program in some way. The regression analysis procedure allowed us to focus in on our one group of participants. There are many benefits of a regression-style analysis. One benefit of the regression analysis is that it can establish future trends. For example, there is a high chance that the way health and wellness programs help one company, will also most likely help the total population. Along with predicting future trends, regression analysis is a simple statistical procedure for our group to conduct. We simply can use the “data analysis” package on Microsoft Excel to get all the data and information we need to review the information from our survey. ResultsAfter receiving sixty participants for our survey our group downloaded our results on to an Excel document. The description of our data was accurate because every participant answered every question, so we received information for all our questions. Also, we allowed participants to know that they have a choice to leave the survey at anytime; we also have a privacy clause in our survey. Once our information was downloaded into an Excel document, we began our analysis. The first step in the data analysis was to add together the amount that each participant uses the health and wellness program. There are different features to the health and wellness program; some employees used less than others. After we totaled the usage amount, we totaled the self-report on job performance, job satisfaction, and the amount of absences.Next, we began to look at the regression between the independent and dependent variables separately. Our results are posted in our Appendix. We broke down the analysis by the three independent variables - job satisfaction, job performance, and absences amount.When analyzing these charts, the numbers that are useful are the coefficients used to determine whether the relationship is positive or negative. All three independent variables have a positive relationship with the usage of the health and wellness plans. This indicates that our hypotheses are correct in the relationship sense. Although our hypotheses are correct, it is important to prove statistical significance. In order to prove statistical significance, the p-value must be less than or equal to .05. Our p-values for job satisfaction and job performance are around .05, so we determined that as statistically significant. One reason the p-value for job satisfaction and job performance may be significant is because at JKJ employees are constantly provided information and helpful tips on their health and wellness. However, the p-value is greater than .05 for absenteeism, so there is no statistical significance for this relationship. Because there is no statistical significance for this relationship, there is another confounding variable causing this positive relationship. Because this is exploratory research, it is hard to determine these possible confounding variables. It would be beneficial to use this exploratory to model a future experimental study on how health and wellness programs can decrease the amount of absences. There could be two groups of participants; a control group and a manipulation group. One group could continue normal health and wellness use and the other could use the health and wellness program in totality. It would be interesting to limit the confounding variables and see exactly what causes the relationship between health and wellness program use and the amount of absences. The results from our experimental study are considered successful for our group because we successfully created a survey and obtained accurate results. Although we only proved two of our three hypotheses have statistical significance, we created the foundation for a future experimental study. We hope that the information we gathered will further the empirical data on the success of health and wellness programs.LimitationsEven though our study was thorough and packed with valuable information and results, there were certain limitations that applied. Our first limitation was the sample size. The sample would be more valid if it were larger. With only 60 employees responses, there was enough information, but it would have given our group more information if we had closer to 200- 400 employees respond. Also, our sample largely consisted of female employees. There could have been more male employees in our study to allow for more variance. It was a random sample so that did add to the validity of our study. JKJ is extremely involved in their employees health and wellness. One reason why our results may have turned out to be significant, except for absenteeism, is due to the fact that the wellness directors are constantly informing and providing employees with up to date information on health and wellness. The JKJ employees are extremely well rounded involving their health and wellness. Another important limitation our study had was that we originally wanted to look at two groups of employees. One group who used the health and wellness program and one group who did not use the health and wellness program. Our survey was constructed in a way that only allowed for the participants to state how much they use the health and wellness program. This changed our whole research design. If we originally considered this option, we would have had more time to prepare more questions on the survey and how our data analysis would be conducted. Although, we faced this issue, we still did an adequate job of putting the results together to prove our hypotheses.DiscussionThere are several important conclusions from the research our group conducted over the past three months. Our group established the importance of using health and wellness programs in organizations. Health and wellness programs can be as small as a free nutrition course during work hours or as large as a free gym in the office. If employees are using more of the health and wellness program, their performance and satisfaction are higher. Not only will the health and wellness programs internally benefit the organization, but there are external benefits as well. Organizations who are hiring the highest performing, most satisfied, and employees who will show up to work everyday, they will be the most competitive company in the industry. Also, the organization is likely saving money on health insurance because they are sending less employees to the doctors office. Again, these monetary savings allow for an organization offering a health and wellness program to be the more competitive company in the industry. Our study can be essential for organizations because it adds to the previously conducted research about health and wellness programs benefits. Our group was pleased with the results and our ability to prove our hypotheses. Our groups final project goes beyond just completing a task for a grade. Our survey and statistics will be used for Johnson, Kendall & Johnson’s future wellness program. Since we worked closely with JKJ, our project will benefit their Health and Wellness department tremendously. They are going to use the results from our survey to modify and change their wellness department. Our survey allowed for two open ended response towards the end. These open response questions asked the employees to suggest alternate ideas and how the wellness program can improve. Mara is an intern for Johnson, Kendall & Johnson and will be presenting our hypothesis and project results to the executive board, and the wellness directors. From our survey, employees noted what aspects of the program they enjoy the most. The JKJ Wellness Directors are going to continue to utilize these programs, and reevaluate programs in which employees do not like as much. Mara recently interviewed JKJ’s President, Julie Bartl and discovered interesting facts about how our survey data will change the employee wellness program. Julie stated, “ Wellness at JKJ and for our clients goes beyond being a program. We view Wellness as an evolution and something that we actively work on each and every day. We encourage our employees and our clients employees to take ownership in their health outcomes by providing resources and tools to achieve a more healthy way of life. We believe and can quantify the impact of our wellness culture through biometric testing year over year results. In addition, we have less people out for illness and injury and our claim trends are declining. More importantly, our preventive screenings are on the rise which we understand is employees being more proactive with their health. The future of the JKJ Wellness program will include options for mental health and wellness and stress management. This is a huge undertaking but something that is extremely important. People with stress and anxiety (which are many) often have physical symptoms or sickness directly related to not being able to deal with or manage stress. We will be introducing a program in February called LifeVest which is an outcome based program that we will measure to key indicators of health (weight and blood pressure). Our employees will be engaged and rewarded for their outcomes through financial incentives” (Bartl). Our project will greatly affect the future of JKJ’s success. As future HR professionals, our group will take the knowledge we have acquired through these surveys and be able to utilize our statistics in real world business situations. Appendix2942574599413002881702301875002515541047100ReferencesBartl, Julie. Personal interview. Dec. 2014.Employee Wellness Programs (n.d.). In Center for Disease Control and Prevention .Retrieved December 15, 2014, from , Ron Z., and Ronald J. Ozminkowski. "The Health And Cost Benefits Of Work Site Health-Promotion Programs." (2008) Annual Review of Public Health 29:303-23.Annual Reviews. Web. 4 Dec. 2014. <10.1146/annurev.publhealth.29.020907.090930>. Holzbach PhD, Robert L., Philip V. Piserchia MS, Deborah W. McFadden MBA, Tyler D.Hartwell PhD, Anthony Herrmann MD, and Jonathan E. Fielding MD. "Effect of a Comprehensive Health Promotion Program on Employee Attitudes." Journalof Occupational Medicine: 32.10 (1990): n. pag. . Web.Kumar, S., & McCalla, M. (n.d.). Operational Impact of Employee Wellness Programs . InInternational Journal of Productivity and Performance Management . Retrieved December 7, 2014, from PSU Libraries . ................
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