barriers, many of which were similar to those expressed by employees. Scheduling and timing of the weekly classes were reported to be difficult because they were conducted during the work day and it was often hard to find a time that employees would be able to attend without disrupting the shift schedules. Attendance was further hindered when sites were short-handed due to callouts (employee calls to inform managers that he/she will not be at work due to sickness, transportation issues, etc), production schedule being behind target, or by continuous service operations (such as retail outlets versus dining halls that had set meal periods and open/close schedules). To better accommodate the busy schedules of foodservice employees, organizers tried to keep the classes short, 15 to 30 minutes. However, it was reported to be difficult to adequately address all of the information within the short class periods. The location of the weekly classes was another important and sometimes difficult factor for organizers to address. On this college campus, employees were spread out over 14 dining locations. With people in so many different locations, it was nearly impossible to find a location that was convenient for all to attend without having to walk or drive. If employees chose to drive, parking spaces are limited and, therefore, created another problem to factor in with transportation. This issue was addressed by alternating the end of campus that classes were held at, but this still did not capture all dining locations, leaving some employees with a travel time to factor in. Finally, program evaluation on knowledge for Wellness Wednesdays was extremely difficult due to low participation rates and regular attendees. An overall knowledge pre/post-evaluation would not have provided accurate information about the effectiveness of the program because all employees did not attend all 10 classes. With such irregular attendance, it was hard to evaluate how effective the program was in relation to lifestyle factors, weight, and health status as well as preventing maximum knowledge gain due to the inability to build on information from one week to the next. A complete list of barriers cited by the program organizer is shown in Table 4. Table 4 does not show percentages of responses because only one organizer was interviewed.
Comprehensive WHP programs are progressively becoming an effective and efficient way to foster behavior change, improve the bottom line of businesses, and lower overall health care costs (Aldana, 2001; Chapman, 2005; Goetzel & Ozminkowski, 2008). Although the evidence of these benefits is vast, reported participation rates are far from what many feel would yield considerably greater benefits. One strategy suggested to improving participation and the effectiveness of these programs is evaluating the perceived barriers and incentives to participation. There are few data on programs that have done this; therefore, the purpose of this study was to determine the perceived barriers and incentives to participation in an existing comprehensive employee wellnessprogram at Weber State University.
Despite government efforts and the use of best practices implemented in wellness programs, these initiatives did not guarantee participation nor program effectiveness (Goetzel et al., 2011; Hopkins, 2007; Nichols, 2012; Pomeranz, 2014). Thus, research posited that despite the type of program, targeted population, budget, and incentives or strategic plans, consistency in participation remained the most substantial culprit to wellness programs (Hopkins, 2007). The ACA opened the door to workplace wellness programs; however, the following barriers were still evident: lack of time, assuage of privacy; compounding injuries, and insufficient employee interests, especially from high- risk employees (Bottles, 2015; R. L. Johnson, 2013; Meyer, Yoon, & Kaufmann, 2013; Montgomery, 2008; T. L. Roberts, 2014; Schopp et al., 2015). Honing in on what behaviors changed an environment and what best practices were required to change the mindset of employees and participants needed a theory-based approach (Gates, Brehm, Hutton, Singler, & Poeppelman, 2006). Therefore, social cognitive theory was selected as a theoretical framework for this study.
Once a person’s class status has been established, one of the main ways through which it is maintained is through participation in activities with people of similar status. Cronin (2009) suggests that sport and leisure pursuits have historically acted as vehicles for maintaining class solidarity as they enable people to sustain social networks and ‘fit in’ with a lifestyle representative of their class status. Two historical studies by Vamplew (2010) and Ceron-Anaya (2010) explore this process specifically in golf. Drawing on extensive archive material, both studies argue that golf clubs were established by the middle-classes in Edwardian times, particularly by men of similar professions, as exclusive environments that would allow the members to gain social distinction (i.e. to separate themselves from the lower classes). Golf clubs introduced and enshrined into their constitutions a series of exclusionary policies and practices designed to “preserve the socio- economic and racial homogeneity of the [club] community” (Ceron-Anaya, 2010). This led to a social system that excluded the working classes whilst enabling the rising middle-classes to create strong social bonds, and even develop business relationships. Historically then, the desire for the middle- and upper-classes to distinguish themselves from the working classes led to policies and practices that, over time, became barriers to both social mobility (i.e. classes would not venture beyond socially defined boundaries), and to participation in certain sports (i.e. those sports that enabled the middle-classes to demonstrate their greater cultural sophistication).
While for some young people (12 per cent) the availability of transport was a barrier or constraint, for more (18 per cent) the cost of transport was the main concern and, arguably, this constraint is more one of finance than transport itself. Indeed, only a minority (ten per cent) of young people considered that the transport in their area was „bad‟ or „very bad‟. Nevertheless, as the most common mode of travelling to a place of learning was by public transport, which was used by 44 per cent of young people, it is apparent that any financial constraints need to be overcome in order for all young people to continue to participate in learning until they are 17 or 18. The importance of this was supported by the fact that 34 per cent of the 144 young people who were NEET or in JWT after completing Year 11 said that they would have gone into education or training if they had received more money to cover the cost of transport. The impact of transport-related barriers was greatest in rural areas. Young people who lived in such areas had significantly increased odds of stating that transport had been a barrier or constraint than similar young people who do not live in rural areas. This suggests that, in order to reduce the impact of this constraint on young people in the context of raising the participation age, there would be value in exploring how to enhance the transport facilities in rural areas and to ensure the affordability of these facilities to young people.
The 2004 National Worksite Health Promotion Survey found five obstacles that impede worksitewellness programs: lack of employee interest accounted for 63.5%; insufficient staff resources contributed to 50.1%; inadequate funds were responsible for 48.2%; failure to engage high-risk employees added another 48%; and the inability to elicit the support of upper management resulted in 38%, with many employers identifying several obstacles (Linnan et al., 2008). Even at companies offering worksitewellness programs, there may be a variety of reasons why employees choose not to participate. Barriers to participation in worksitewellness programs among employees include lack of time to participate, resistance to breaking old habits, structural barriers, a perception that wellness programs are contrary to their work culture, and/or skepticism about management‟s commitment to improving employees‟ health (Lassen, Bruselius-Jensen, Sommer, Thorsen, & Trolle, 2007; Person, Colby, Bulova, & Eubanks, 2010). Personal privacy can be an issue for employees because making healthy personal behavioral changes may be a sensitive topic. This is particularly true for older workers with multiple health problems, who see company involvement in their health as an intrusion to their privacy (Robroek, van de Vathorst, Hilhorst, & Burdorf, 2012).
California’s Global Warming Solutions Act of 2006, also known as AB32, aims to reduce the state’s GHG emissions by 2050 to 80% below 1990 level (California Air Resources Board 2015b). The California Air Resources Board (ARB), a division of the California Environmental Protection Agency (EPA), administers the program and provides support for forest projects and entities that are mandated to reduce their greenhouse gas emissions. The policy operates under two frameworks: regulatory and voluntary. The mandated components are the yearly reductions in carbon dioxide emissions, about 3% per year from 2015 to 2020. A covered entity must reduce its carbon dioxide output, but the ways in which it chooses to do that can vary. Another viable option is to instead invest in carbon credits. The voluntary part of this operation comes from the viewpoint of a landowner initiating an offset project. The landowner may choose to voluntarily enter the forest carbon offset market. This means that the landowner will attempt to preserve and increase the carbon stocks in and derived from the trees in the project.
Many adults spend a majority of their time in a sedentary work environment. However, the workplace can be an ideal location to promote physical activity and healthier lifestyles. Creating a health-promotion program can raise awareness of the importance of physical activity, as well as provide incentives for engaging in a physically active lifestyle. According to Baicker and associates (2010), a company will see various benefits from health promotion programs including reductions in medical cost, greater productivity, and a decrease in absentee days. After implementation of health-promotion programs, companies observed a drop of $3.27 in medical costs for every dollar spent on the program. The companies also observed a drop in absentee days, which saved $2.73 for every dollar spent on the program (Baicker, Cutler & Song, 2010). These numbers are associated with the fact that, in general, health programs promote healthier lifestyles and behaviors. The change in behaviors and choices decreased the number of medical visits and sick days employees took each year. This significantly reduced health care cost for companies involved in various worksitewellness programs (Baicker et al., 2010).
Since the 2011 –2012 academic year, the district has utilized a well- ness program provided by WellSteps, LLC. The program incorporated known practices thought to improve the health of employees, including several of the components of a successful program noted in the review cited above ( Kaspin et al., 2013 ). The aim of the program was to improve employee health behaviors, lower elevated health risks, pre- vent chronic diseases, and consequently, curb increasing healthcare costs. Previous research has assessed health behaviors and outcomes in the district ( LeCheminant et al., 2015; Merrill and Sloan, 2014 ). The district program is unique in that it was applied over 3 years to a multi-site school district with the majority of the employees being teachers. Little evidence is currently available showing the effect of the wellnessprogram on healthcare costs over time for this population. The purpose of the current study was to extend previous research by evaluating the extent participation in the worksitewellnessprogram was associated with frequency and average cost of submitted medical claims. Participation in the wellnessprogram was also assessed by age and sex, and the association between wellnessprogramparticipation and the primary outcome measures were adjusted for these variables. We hypothesized that wellnessprogramparticipation would differ according to age and sex, and that it would be associated with the fre- quency and average cost of submitted medical claims, after adjusting for age and sex.
Two surveys were administered prior to the start of the program. The first survey, Physical Activity - Barriers Questionnaire (Appendix E) was adapted from the Centers for Disease Control (CDC) Barriers to Being Active (Appendix H). This instrument provides an assessment of the following barriers to participating in regular physical activity: lack of time, social influence, lack of energy, lack of willpower, fear of injury, lack of skill, and lack of resources. The CDC developed this quiz as a method for individuals to assess their personal barriers to engaging in regular physical activity (Overcoming barriers to physical activity.2017). As a survey however, responses to the twenty-one-question assessment were consolidated and analyzed to assess for any commonality with the study group. Demographic questions were added to further analyze for any similarities or differences based on age, gender, relationship status, household size, and number of dependents. The assessment is a four-point matrix rating scale, which asks respondents how likely they are to say 21 different statements. Each statement represents one of the five barriers. Response choices were: very likely, somewhat likely,
The first aim of this study was to document the level of employee participation in the WWOCA over a three-year period. The second aim was to assess health outcomes achieved by participants in the WWOCA program in which employees received a reduced monthly health insurance premium contingent upon their achieving a previously-identified physical health goal set by a licensed trainer. The third aim was to explore participant perspectives on the benefits and challenges related to participating in the WWOCA program at their workplace. In general, there is a dearth of research about current organization knowledge regarding how non-managerial employees experience their worksitewellness programs (Gates, Brehm, Hutton, Singler, & Poeppelman, 2006; Makrides, Heath, Farquharson, & Veinot, 2007; Wood & Jacobson, 2005).
wellness and only 30% or less of respondents utilizing current wellness programs offered to faculty and staff, the findings of this study are similar to those found by Linnan et al. (2008) during a nationally representative, cross-sectional telephone survey of worksites drawn from the Dunn and Bradstreet database of all private and public employers in the continental Unites States. They found that the most common barriers to offering health promotion and worksitewellness programs listed were a lack of employee interest a lack of support by management, a lack of resources and funding, as well as a lack of participation by high risk employees (Linnan et al., 2008). The decision to adopt a health promotion program often relies on the support of just a few individuals in senior management. According to Weiner, Lewis and Linnan (2009); “the implementation of worksite health promotion programs should be regarded as an organizational act and the successful implementation of such programs viewed as an organizational issue” (p. 294). It may be beneficial for the university to do a leadership support audit at all levels of leadership to determine if this perception of the respondents is accurate.
Weather frequently delayed travel, especially by air. Staff had to respond immediately to delays and flight cancellations. Fortunately, the team observed a business culture in Alaska that was patient and understanding of such unpredictable obstacles. In addition, they learned to be respectful of local fishing and hunting seasons. In communications with candidates for study recruitment, they regularly inquired about seasonal aspects of business operations and workforce participation. This sensitivity and flexibility required extra time and lengthened the recruitment schedule, but it also enabled the enrollment of businesses that might otherwise have declined participation.
Organizations are often faced with the challenge of showing wellnessprogram cost savings when there is a lack of employee participation (Benevides & David, 2010), making it critical that systematic efforts are made to keep long term, sustainable participation high. Many evaluation studies of wellness programs compare employees who enrolled in programs to those who did not, and the challenge is “to show that wellness programs can do more than just reward the already healthy or prompt improvements that will yield benefits” (Kirkland, p. 963). This challenge is exasperated by barriers to wellness implementation, which include “not enough time for workers to participate, dispersed population and difficulty keeping momentum going with efforts” (Mrkvicka, p. 31).
Oneida County Health Department has achieved national accredita- tion through the Public Health Accreditation Board (PHAB). The na- tional accreditation program works to improve and protect the health of the public by advancing the quality and performance of the nation’s Tribal, State, Local, and Territorial public health departments.
related to motivational factors associated with being part of the weight loss initiative. The competitive nature of the initiative kept members focused on attending the gym and maintaining a consistent workout routine. Respondents felt that the weight loss initiative provided a goal-oriented environment that was conducive to losing weight and achieving a healthier lifestyle. Additionally, respondents identified the varied types of workouts and classes as a means for keeping them motivated, which also made their weight loss journey more interesting. Respondents also identified both the one-on-one personal training and the multiple resources available at the wellness center as an important factor in motivating members to successfully progress through their weight loss journey. Respondents also suggested a strength of the weight loss initiative was its impact on improving overall health habits of its members. Participation in the initiative provided discipline and a mindset to build positive health habits and improve overall lifestyle. Finally, the competition style initiative provided the motivation for both individuals and their respective teams to work consistently towards achieving their weight loss goals.
Another way to focus on maintaining interest is to package your activities wherever possible to let them build off of each other. by providing the right mix of programs, you can get a multiplier effect that is greater than the individual activities added up. packaging related strategies will lead to greater participation and long-term success. for instance, having a policy that encourages physical activity on break time, coupled with using pedometers as incentives and then providing maps or on-site trails to get staff out walking, will lead to greater success. once you start a program you will have a range of employee participants. some will already be very engaged in being active, eating well and doing stress management, and your program will only reinforce and enhance their health. on the other end of the spectrum will be people who may not engage no matter what you do. The remaining group is probably the largest group in most organizations: people who are at various stages of readiness to improve their health given the right type of programming and motivation. some tips you may want to employ once your program is up and running are on the following page.
A budget must be established in order to estimate the cost and spending of planning a wellnessprogram. Costs could include incentives, renting space for activities, equipment used during activities, hiring staff, and promotional material. These items can also be obtained through in-kind donations, but still should be included in the budget. It is important to note whom the key stakeholders and funders will be, how much they are willing to contribute, and how to address any financial gaps. This leads to the formation of partnerships and the identification of resources already available to control costs and reduce spending.
A data form was used to extract information on the number of participants, the target population, demo- graphic (e.g. sex, marital status) as well as health- (e.g. physical activity, weight) and work-related (e.g. job type, company size) determinants of participation. Finally, pro- gramme characteristics as the availability of incentives, the requirement of paying a fee to participate, the pro- gramme type and the targeted behaviour were obtained. The first author (SR) performed the data extraction and the last author (AB) verified all extracted data. In case of doubt, data were discussed until agreement was reached. After the data extraction, programmes were divided in three groups: (1) programmes with a fitness centre or exer- cise programme as main component, (2) with education or counselling as main component, (3) and multi-compo- nent programmes. One study evaluated a fitness centre programme next to a multi-component programme, and described the determinants of participation in both pro- grammes separately . The determinants of this study were considered separately for both programmes, result- ing in 22 publications describing 23 studies.