Business Research

Thousands of Readers Drawn to Workplace Wellness Research

A subject that affects everyone, a quest for facts, and a formula that provides cost savings for businesses created a hit combination for a Baylor professor and her colleagues testing theories about workplace wellness.

After hundreds of interviews across a spectrum of industries, Ann Mirabito and two coauthors determined that successful wellness programs require six components and put forth their findings in an article. Harvard Business Review fast-tracked the piece, and the trio's research came out in the December 2010 issue. Months later, reviews and queries are still coming in. One online story about their story has been viewed more than 10,000 times.

Mirabito and colleagues Leonard L. Berry at Texas A&M and William B. Baun at MD Anderson Cancer Center get to the heart of the matter quickly in the article, "What's the Hard Return on Employee Wellness Programs?" A subhead reveals, "The ROI data will surprise you, and the softer evidence may inspire you." The paper then unwraps the case for well-planned programs, revealing the "hard return" like a birthday present for business.

The research attracts interest because of the costs of health care, said Mirabito, an assistant professor of Marketing. "And also because America is getting less healthy every day," she said. "We have done so much to eliminate many infectious diseases. What is crippling us now is chronic disease."

She offers these facts:

•Many companies will spend more on healthcare than they will earn in corporate profits.
v bbbb •Before GM was restructured, GM spent more on health care than on steel.
•Three-fourths of health care spending is related to chronic disease, and much of thabbt is related to lifestyle.

Complex factors contribute to unhealthy lifestyle behaviors, and simple messages like "eat better and move more" result in only modest impact on behavioral change. Still, she noted, many companies have been reluctant to become enmeshed in their workers' health care because health is a private matter. But some firms have been innovative in improving health care offerings, and she and her colleagues, who have studied business-medical collaborations for years, decided to study workplace wellness programs that make a difference.

The research team examined existing research and wellness programs at 10 companies with reputations for "excellent workplace wellness programs," Mirabito said. They talked to about 300 people in interviews that lasted from 25 minutes to an hour.

"We interviewed the CEO, the CFO, the vice president for HR, people in charge of wellness programs, middle managers," Mirabito said. "And then we interviewed the employees who used the program and the employees who did not use it. We asked people different questions depending on who we were talking to." For example, they asked company leaders their original motivations. Had those motivations changed? They asked about benefits, challenges, and, if the leader had a "do-over," what would it be?

They asked users and non-users of workplace programs about what they liked best, what they wished the programs included, and why they used it or did not use it.

"We took online, real-time notes and reviewed transcripts, and six themes came out," she said. "We reviewed the workplace wellness literature. We validated our findings with further discussion with the sample companies and with other workplace wellness experts."

Although wellness programs have been around since the 1970s, the business case for them has been elusive. Mirabito and her fellow researchers discovered that sound, well-planned programs boost business in three ways: lower health care costs, higher productivity and a stronger organizational culture and morale, which means less employee turnover and more loyalty.

So what does workplace wellness involve? Does it mean you build a gym and, voila, employees are healthier? That might be part of it, Mirabito said, but an effective program is built on six pillars.

1. Multilevel leadership. This includes participation by the company's top leader and by middle managers, wellness program managers and wellness "champions."

2. Alignment. Important to this pillar is making wellness a part of company culture, which takes both patience and planning. As the paper says, "organizations in our sample favor positive incentives because employees lose trust when they feel they're being forced to act against their wishes." Mirabito said it takes at least three years to establish a wellness culture.

3. Scope, relevance and quality. Successful wellness programs are broad, focusing on the whole person and individual needs rather than only select items such as diet, cholesterol levels and exercise. Programs that work best recognize the devastating effects of stress, for example, and offer counseling for a whole range of ills, from divorce and depression to investment counseling. As the article says, these programs are "just plain excellent. Otherwise, employees won't participat."

4. Accessibility. From offering healthy food and snacks at work to health fairs and exercise centers that people can fit into a workday, making wellness easier to attain is integral to a successful program. At the software company SAS, 70 percent of employees use a campus' recreation center twice a week. The director said leaders thought of the reasons people would not use it and "worked to eliminate every one of them."

5. Partnerships. Communications company Comporium worked with the YMCA to develop "metabolic makeovers" for at-risk workers. Home products giant Lowes had mobile labs visit stores and other worksites for employee convenience.

6. Communications. Talking about the wellness program is important for buy-in, and tailoring the message to individuals is important, the researchers found. One firm with a competitive corporate culture devises wellness scorecards for company units to emphasize the health message. Also an important part of communicating is using diverse means to dispense the message, from flyers in elevators to fruit dropped on desks as event reminders.

Assessing how the programs work helps connect the investment to the results. So Mirabito and her researchers created a dashboard that shows companies how to measure wellness objectives.

"In the same way a marketing initiative's impact is measured through market share, revenue, profitability, customer satisfaction and loyalty, there is a similar set of diagnostics for workplace wellness programs," said Mirabito, who teaches Principles of Marketing to primarily junior and senior students. The researchers found that the most useful yardsticks for employees were participation and satisfaction, and for organizations, financial productivity and cultural outcomes.

"What we found again and again was the notion that workplace wellness is good for the employee and good for the firm," Mirabito said. Terry Heimes, CFO at education planning and finance firm Nelnet, told her: "If your only reason is to cut health care costs, you won't get employee buy-in and support because there's nothing motivating for anyone other than senior management."

"The whole win-win notion is really important," Mirabito added. "If all the firm is interested in is cutting costs, there are many ways to do it. That is not the motivator for the firms investing in workplace wellness. They do it because it's good for employees and the firm."

She and her colleagues discovered that firms with quality wellness programs were quick to participate in the research. They were interested in an independent review of their program. The researchers helped them identify strengths and opportunities.

"Also, they were very interested in helping to make it easier for other companies to adopt workplace wellness programs," she said. "The biggest reason more companies don't offer workplace wellness is uncertainty about what workplace wellness is, why it is important, and what kinds of benefits a firm can expect. These are the important questions we sought to answer."

Mirabito's article is a success, ranking as a top three download from Harvard Business Review's website in December 2010, its month of publication. Several months later, entering the article title into search-engine giant Google yielded more than 100 hits. Meanwhile, two follow-up articles, one designed for physicians and one for workplace wellness leaders, are in the works.

"The article is making a big splash because it offers employers a blueprint for effective workplace wellness programs," Mirabito noted. "Workplace wellness might seem simple, but it's complex in the same way marketing is complex. Some might think of marketing as creating a funny commercial and airing it during the Super Bowl. But strategic marketing involves setting objectives and identifying strategies to achieve and tactics to support those strategies."

Ann Mirabito
Baylor University