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Original Investigation
May 26, 2020

Effects of a Workplace Wellness Program on Employee Health, Health Beliefs, and Medical Use: A Randomized Clinical Trial

Author Affiliations
  • 1Department of Finance, University of Illinois at Urbana-Champaign
  • 2National Bureau of Economic Research, Cambridge, Massachusetts
  • 3Center for Health Policy, Stanford University, Stanford, California
  • 4Center for Innovation to Implementation, Veterans Affairs Palo Alto Health Care System, Palo Alto, California
  • 5Harris School of Public Policy, University of Chicago, Chicago, Illinois
  • 6Department of Recreation, Sport and Tourism, University of Illinois at Urbana-Champaign
JAMA Intern Med. 2020;180(7):952-960. doi:10.1001/jamainternmed.2020.1321
Key Points

Question  How does a comprehensive workplace wellness program affect health, health beliefs, and medical use among university employees after 24 months?

Findings  In a 2-year randomized clinical trial of 4834 employees at a large US university, employees invited to join a wellness program showed no significant differences in biometrics, medical diagnoses, or medical use relative to the control group. The intervention increased self-reports of having a primary care physician and improved a set of employee health beliefs among the treatment group.

Meaning  The workplace wellness changed health beliefs and increased self-reports of having a primary care physician but did not significantly affect clinical outcomes.


Importance  Many employers use workplace wellness programs to improve employee health and reduce medical costs, but randomized evaluations of their efficacy are rare.

Objective  To evaluate the effect of a comprehensive workplace wellness program on employee health, health beliefs, and medical use after 12 and 24 months.

Design, Setting, and Participants  This randomized clinical trial of 4834 employees of the University of Illinois at Urbana-Champaign was conducted from August 9, 2016, to April 26, 2018. Members of the treatment group (n = 3300) received incentives to participate in the workplace wellness program. Members of the control group (n = 1534) did not participate in the wellness program. Statistical analysis was performed on April 9, 2020.

Interventions  The 2-year workplace wellness program included financial incentives and paid time off for annual on-site biometric screenings, annual health risk assessments, and ongoing wellness activities (eg, physical activity, smoking cessation, and disease management).

Main Outcomes and Measures  Measures taken at 12 and 24 months included clinician-collected biometrics (16 outcomes), administrative claims related to medical diagnoses (diabetes, hypertension, and hyperlipidemia) and medical use (office visits, inpatient visits, and emergency department visits), and self-reported health behaviors and health beliefs (14 outcomes).

Results  Among the 4834 participants (2770 women; mean [SD] age, 43.9 [11.3] years), no significant effects of the program on biometrics, medical diagnoses, or medical use were seen after 12 or 24 months. A significantly higher proportion of employees in the treatment group than in the control group reported having a primary care physician after 24 months (1106 of 1200 [92.2%] vs 477 of 554 [86.1%]; adjusted P = .002). The intervention significantly improved a set of employee health beliefs on average: participant beliefs about their chance of having a body mass index greater than 30, high cholesterol, high blood pressure, and impaired glucose level jointly decreased by 0.07 SDs (95% CI, −0.12 to −0.01 SDs; P = .02); however, effects on individual belief measures were not significant.

Conclusions and Relevance  This randomized clinical trial showed that a comprehensive workplace wellness program had no significant effects on measured physical health outcomes, rates of medical diagnoses, or the use of health care services after 24 months, but it increased the proportion of employees reporting that they have a primary care physician and improved employee beliefs about their own health.

Trial Registration  American Economic Association Randomized Controlled Trial Registry number: AEARCTR-0001368

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    2 Comments for this article
    This is the 12th consecutive study to find no impact
    Al Lewis, JD | Quizzify
    For years I've been observing (not opining, observing) that wellness loses money and has no noticeable impact on employee health. Except, that is, when it has a negative impact. https://www.statnews.com/2016/09/27/workplace-wellness-award/

    Prior to this, 11 consecutive studies have shown that wellness doesn't work. https://www.benefitnews.com/opinion/time-to-believe-why-wellness-isnt-lowering-healthcare-costs

    Further, there are serious concerns about the ethics of wellness companies and consultants. https://scholarlycommons.law.case.edu/healthmatrix/vol27/iss1/3/

    It is time to regulate this industry and require, at a minimum, that wellness vendors adhere to US Preventive Services Task Force guidelines, instead of forcing employees to choose between fines or inappropriate testing.
    Abstract lacks data
    Denice Ferko-Adams, MPH, RDN, FAND | Wellness Press, LLC
    In this abstract, there are no data listed on the number of participants who actually participated in and completed the interventions. The abstract lists disease management but nothing on disease prevention.
    Who led the interventions?
    Was pre and post qualitative data collected and used to alter the subsequent interventions?
    Were the employees involved in the design of the interventions and the appropriateness of the incentives?
    Change is also necessary in the worksite environment such as easy access to educational and preventive services, options for delicious healthful cafeteria choices, fitness opportunities (as simple as walking routes) and management training
    on why they need to support these efforts.
    Having developed, customized, delivered, collected pre/post qualitative and quantitative data - and used standards above the US Preventive Services Task Force guidelines .
    I agree that there needs to be much higher standards and companies create an environment that promotes health for the employee, family members and communities they serve.