According to Zoller, scholars and/or practitioners proponents of workplace health promotion (WHP) generally assume that employees universally welcome the programs. Perhaps, the primary delimitation that could be contributed to health and wellness programs would be that one of the other would not be wanted by employees. Consequently, health promotion literature that deems the programs to be "pro-social" endeavors designed in employees' best interests frequently fail to engage employees' participation.
Additional delimitations incorporate:
Failure to adequately engage employee needs
The development of divisive gender issues and Reliance on disciplinary models of health contributed to negative reactions and lower employee participation." (Zoller)
Smoking, Diet and Exercise in 1996, approximately nine out of ten major employers offered health promotion programs which ranged from fitness centers; health testing; health education programs; incentive/disincentive programs to increase health behaviors like dieting or cease smoking; health outcomes (lowering body fat levels and/or cholesterol). By changing employees' voluntary habits (including smoking; diet; exercise), some employers purport they can reduce health care costs.
Zoller, however, disagrees. Even though.".. literature suggests that health programs boost morale, produce employee cohesiveness and teamwork, and improve employee health through the promotion of self-discipline and lifestyle change," Zoller presents contradictions these positive assumptions in his study and cites.".. how choices made in constructing this WHP facility and program fostered employee morale problems, divisiveness, and alienation among some employees."
Claims by WHP that workplace initiatives improve employees' mental and physical health, with ensuing improvements in efficiency; morale; commitment; loyalty and help secure more profits for employers have not always proven true, Zoller stresses. Even though some studies show health promotions decrease health care and disability costs; other reports confirm delimitation, as health and wellness programs may trigger increases in unneeded tests and doctor visits. Reports of improved resting heart rates, blood pressure, and total cholesterol levels or individuals, who exercise in corporate programs, Zoller argues, are apt to.".. be young, white-collar workers who are healthy, affluent, and already exercising, while those most in need of exercise to improve their health are less likely to participate." Real experiences and negative reactions to health and wellness programs are sometimes ignored and/or "overlooked" when researchers are seeking measurable outcomes.
Gemeinschaftsgefuehl, one of Adler's terms with no reported literal translation, means "social interest." (Myers, Luecht, and Sweeney) Rather than this term or social support as an extenuating factor for positive mental health, relational wellness may be deemed nearer to Adler's concept.
Spiritual connectedness, also derived from Alder, additionally serves to motivate individuals. Myers, Luecht, and Sweeney include these concepts, along with the wellness model, contrasted to the medical or illness model emphasizing disease and disability. The wellness model has become more popular as a strengths-based, positive, integrative, and holistic approach to human functioning understanding. In the study completed by Myers, Luecht, and Sweeney: "The 5F-Wel was administered to 3,993 volunteers over a 4-year period. The data were collected in conjunction with various research projects; clinical counseling assessments; wellness workshops; and both undergraduate and graduate courses in counseling, helping skills, and life-span development (i.e., the data were codified across multiple sources). All participants were volunteers who agreed to allow their data to be used for research purposes." One factor not yet addressed in wellness assessment, this study noted, consists of contextual factors influence on human functioning. A strong relational factor presence, incorporating aspects of one's environmental connection, implies, as this study hypothesized, that context does, in fact, affect an individual's well-being, one more delimitation that can be connected to health and wellness programs. The authors of this study, however, admit that currently, ways wellness differs among nonclinical and clinical samples is not known.
According to the "State Employee Wellness Initiatives" brief published in 2005, because state government constitutes the biggest single employer and health coverage purchaser in numerous states, state employee wellness programs are serve as pilots for health initiatives. Wellness and prevention programs primarily promote healthy habits, an understanding of particular lifestyle risks managing diseases and engaging in regular exercise. "Citing rising health care costs and alarming health statistics, several governors have implemented wellness and prevention programs in their states in the last few years."
Programs traditionally are categorized as:
Programs offering health assessments and monitoring
Health insurance incentives, ranging from discounts for nonsmokers to financial rewards for enrollees who reach personal health and fitness goals.
Healthy work environment initiatives, such as banning smoking near state office buildings and recognizing healthy worksites with awards
Fitness challenges and events, such as weight loss challenges, wellness expos, walking programs, and programs in which employees receive pedometers if they participate in a fitness challenge or health screening." ("State Employee Wellness Initiatives.")
State governments, the brief purports, serve as models to the private sector. Implementing a prevention and wellness program can help improve employees' health; augment productivity and morale. (Ibid) Some research strongly supports this supposition, while other works challenge the positives proposed through implementing wellness programs.
State Employee Wellness Initiatives")
After making a public announcement to become healthier, Georgia's Governor Sonny Perdue began the "Governor's Challenge: Fitness on My Mind," also, referred to as the "Capitol Challenge." 1,800 state employees reportedly accepted Perdue's health challenge. ("LOCAL PROFESSIONALS CONTRIBUTE...")
Public and private employers' reasons reported for starting wellness programs may stem from CEOs' personal health experiences, to vice presidents' agendas wanting to counter continuing yearly increases in health insurance premiums to... Whitson argues, however, that no matter the reason, the value for wellness programs is generally double:
1) There are tangible benefits to be gained, such as cost-savings; and 2) There are intangible benefits, such as improvements in employee morale." (Whitson)
Tangible benefits include the usual reports of:
Reduced sick leave/absenteeism
Reduced use of health benefits
Reduced workers' compensation
Control of health insurance premiums
Lower turnover." (Ibid)
Whitson reports intangibles benefits to include the usual:
Improved employee morale
Increased employee loyalty
Reduced organizational friction
Better employee decision making." (WHITSON)
WHITSON, on the other hand does go a bit further than citing usual benefits as he presents suggestions to counter limitations generally accompanying health and wellness program. Same basic program "Do's and Don't's:
1) Make the program voluntary;
2) Continually market it to employees;
3) Be sensitive to age and body limitations as well as cultural differences;
4) Make the program as flexible as possible;
5) Evaluate the program frequently;
6) Make sure the management staff is modeling healthy behavior;
7) Reward the people who have helped put the program together;
8) Keep good records in order to properly evaluate the program;
9) Provide a balance of fun programs and those that are clinically significant;
10) Personalize the program to the workers' needs."
To measure a health and wellness program's success, fitness classes' participation levels need to range from 40 to 80%, with new member regularly joining. Individuals who are replacing unhealthy habits with more positive ones should measure from 10 to 35%, as evidenced by healthier food choices; exercising regularly; maintaining ideal weight; ceasing smoking.
Absentee rates should decline between 20 to 70%. Although monitored measurements will be dependent on employees' following through with program, as well as, program's intensity, health care costs should decrease between five to 25%. (Ibid)
The Wellness Policy presented on the website for the Southwest Health District, a 14 county public health district for over 300,000 citizens cites their mission.".. is to prevent disease, injury, and disability; promote health and well-being; and prepare for disasters." ("Wellness Policy.") the District Health Director encourages employees to make positive mental and physical lifestyle choices. Wellness breaks throughout the workday are also authorized help employees meeting their health-oriented goals.
Guidelines for use of wellness breaks include:
maximum of 30 minutes in a given workday may be used to engage in wellness activities, generally in the form of two 15-minute breaks or one 30-minute break
Employees will sign out and/or clock out for wellness breaks as appropriate to their work site
With sufficient justification and accountability, supervisors may allow staff to combine wellness breaks with lunch breaks or to use wellness break time at the beginning or end of the day
Wellness breaks cannot be taken in addition to other breaks
Wellness breaks may be used for activities including but not limited to:
Walking or jogging
Workout at gym
Meditation and other activities to improve emotional/mental health
Counseling, educational training, and support functions for behavioral modification (i.e. tobacco and other addictions)." (Ibid)
The above four components: Proper Nutrition; Increase Physical Activity; Stress Reduction; Smoke Free are repeatedly stressed for major focus of Health and Wellness Programs.
Conway, et al. cautions that wellness programs may become a legal trap for unwary employers issues under ERISA, HIPAA, ADA and COBRA, and could adversely affect employees' abilities to participate in a health savings account (HSA) if an employers have a high-deductible health plan. Implementing proper plan design, however, reviewed by legal counsel, will help insure an employer's wellness program doesn't sicken the company's status.
III. Methodology - to be completed/complemented with…