Workplace Wellness - Barriers

Barriers

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 worksite 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 significantly limit the potential benefits. Little is known or reported about the determinants of participation, but some clues are emerging. Ongoing management support and accountability are critical to successful worksite health promotion programs. Men and women participate in different types of activities, and white-collar employees engage in activities at a greater rate than blue-color employees. There are legal and ethical issues to consider as well including obtaining participant release forms, and maintaining employee confidentiality, especially concerning health risk appraisals and other information protected under federal law. One reason for low participation rates may have to do with the messaging associated with the policy or program. In order to motivate or persuade employees to participate and change behavior, messages should be individually targeted which results in more significant positive attitude change.

Workplace wellness programs should also be culturally sensitive and appropriate to economically challenged minority and other underserved populations. One of the strongest predictors of health status is socioeconomic status (SES), and the gap between SES groups is widening (Thompson). Research is being conducted to better understand the challenges and come up with solutions. One idea involves soliciting the assistance of member of the community and giving ownership of the program to the employees. This approach is based on Bracht’s 5-stage community organizational model for health promotion with adaptations for the worksite. Restrictive participation policies (e.g., off-the-clock scheduling) for onsite health promotion activities such as health screenings, health risk appraisals, and workshops may act as a barrier to participation and therefore have a negative impact on health outcomes and effectiveness.