Wellness and fitness programs sponsored by and conducted in organizations have historically aimed at enhancing individual health, providing health risk screenings, avoiding the burden of suffering associated with distress, health, and safety problems, and reducing the organizational costs of distress at work. Because cardiovascular disease continues as the leading cause of death for men and women in the American workforce, many wellness and fitness programs have been designed around aerobic or cardiovascular fitness. However, in the workplace itself, the greatest health risks for men are industrial accidents and for women are incidents of homicide. This has been true through much of the twentieth century. Therefore, early health promotion programs in industry focused on workplace safety and later gave way to ergonomic programs that focused on worker-environment fit. These two early health initiatives were followed by the advent of wellness and occupational health promotion programs, many based on an allopathic medical model. This medical model gave way to a preventive medicine one as used, for example, in the Duke Executive Health program.
To examine the current state of the practice and science of wellness and fitness programs, we look first at the early foundations for wellness and fitness programs. Second, we turn to positive health versus health-risk management. Third, we consider a three-level typology of wellness and fitness programs. Fourth, we examine the impact of these programs. Finally, we identify success factors for wellness and fitness programs.
Early Foundations Of Wellness And Fitness Programs
The health of a workforce is of concern for both humanitarian and utilitarian reasons, and there is interdependence between the health of the employee and the health of the organization. Hugo Munsterberg’s turn of the twentieth-century research on industrial accidents brought attention to the importance of workplace safety in America. Throughout the century, workplace safety was a concern in manufacturing and industrial work environments. The Occupational Health and Safety Act (OSHA) of 1970 brought forth a wide variety of regulations and practices that advanced safety practices in the workplace. The focus in these programs was problem avoidance as opposed to health enhancement and was very compatible with the broadly accepted allopathic medical model that is symptom and disease oriented. Thus early wellness and fitness programs that grew up during the 1970s and 1980s often emphasized addressing unhealthy behaviors, such as smoking, substance abuse, poor diet, and lack of exercise. In addition, the emphasis was on individual behavior in contrast to characteristics of the workplace. With the advent of Kenneth Cooper’s preventive approach through aerobic exercise in the 1970s, the broader increasing emphasis on preventive medicine at the same time, and the impact of the osteopathic medical model, the early approaches to wellness and fitness promotion gave way to new ideas, approaches, and practices in health, wellness, and fitness.
Positive Health Versus Health-Risk Management
Wellness and fitness programs typically focus on the promotion of positive health and/or the prevention and resolution of health risks. Inherent in these themes are the perspectives of health as the presence of positive states or health as the absence of illness. Both psychology and medicine have historically focused primarily on preventing health risks and healing disease and illness, and consequently, early wellness and fitness interventions followed within this tradition. Recent calls have been made, in contrast, for a focus on health defined as the presence of the positive in both mind and body. The positive psychology movement, pioneered by Martin Seligman and colleagues, emphasizes psychology as a science of human strengths, some of which lead to flourishing and others that act as buffers against illness.
Reflecting this movement toward a more positive view of both physical and mental health, wellness and fitness programs are increasingly including components that promote resilience and positive health as well as the management and identification of health risk factors. Thus the content of these programs includes both health-enhancing activities as well as health risk management activities that encompass health in its broadest definition. Among the goods that are essential to positive human health are having a purpose in life, quality connections to others, and positive self-regard. Aristotle long ago proposed that the highest of all human goods was the realization of the individual’s true potential, which he described as eudaemonia. Wellness and fitness programs thus belong squarely within the realm of career development, as the career facilitates all of these goods. Development of these goods requires the effort of both individuals and organizations.
In addition, the emphasis on health has grown to include not only individual health but also organizational health, as articulated in the preceding section. Healthy organizations consider multiple levels of health (individual, group, and organization). They promote organizational congruence, or fitness, between the organization and its external environment, and between components within the organization.
In summary, a broader, more positive view of health has evolved. This comprehensive view emphasizes positive health, along with health-risk management, and encompasses both healthy individuals and healthy organizations.
Types Of Wellness And Fitness Programs
As the broader conceptions of health and wellness have evolved, so too have the typologies of interventions offered by organizations. An early typology offered by several researchers proposed three levels of health programs:
- Level I: Awareness programs, including newsletters, health fairs, screening sessions, education classes, and other activities that raise individual awareness of the consequences of unhealthy behaviors
- Level II: Specific programs for lifestyle modification, including fitness programs, back exercises, and the like, characterized by active employee involvement in adopting health-promoting behaviors
- Level III: Programs that create environments in which individuals can sustain healthy lifestyles over the long term, including the provision of fitness centers at the workplace, making healthy food available, and removing unhealthy food from the workplace.
From these three levels, fourth-generation programs evolved, variously referred to as total health programs, comprehensive health promotion programs, or health and productivity management programs. Johnson & Johnson’s Live for Life program represents one of the earliest comprehensive wellness programs. Three key components of the J&J program are health risk assessment, creative educational units, and physical fitness training. Health risk assessments may include analyses of stress management, fitness, nutrition, safety, and ergonomics, and the assessments are used to identify the individual’s strengths and weaknesses. In the educational units, a wide variety of media is used to deliver education on such topics as weight management, smoking cessation, women’s health issues, and blood pressure management, among other health-related subjects. In J&J’s physical fitness training, programs are tailored specifically to individual needs. Evaluations of the Live for Life program have indicated positive effects on exercise, health behaviors, and employee work attitudes.
Kimberly-Clark Corporation’s Health Management program is also a benchmark comprehensive program, initiated in 1977. The program reflects the company’s culture and its belief that well-informed, healthy employees are happier, safer, more productive, and have better attendance records, and that these factors produce lower health care costs for the organization. Integrated, multidisciplinary teams provide health screening, primary care, exercise programs, nursing care, and employee assistance programs at Kimberly-Clark’s various locations. Fitness facilities include indoor running tracks, Olympic-size pools, nature trails, weights, and aerobic equipment. Preventive and educational services are provided, which include family wellness, nutrition education, CPR training, and sport-specific workshops, among other programs.
Health and productivity management programs (HPM) have three basic goals: (1) to provide integrative services that promote employee health or assist with injury, illness, or work-life balance, (2) to increase productivity and morale, and (3) to manage medical benefits, risk management, employee assistance programs, and other services such that they promote health and productivity. Keys to the success of HPM programs include health promotion and wellness staff who serve as models of healthy lifestyles, employee empowerment, and self-responsibility. The distinguishing factor of HPM programs is the tie to the mission of the business and articulation of the links between individual health and business operations.
Positive Impacts On Individuals, Careers, And Organizations
There are five positive impacts that proceed from wellness and fitness programs in organizations that have effects on individuals, careers, and organizations: (1) employee physical and psychological health, (2) employee engagement and involvement, (3) health care cost avoidance, (4) reduction in absenteeism, turnover, and injury, and (5) high performance on the job and morale at work.
Physical exercise programs that address the employee’s cardiovascular fitness, muscular flexibility, and muscular strength lead to improvements in employee physical health and well-being with a number of associated improvements in psychological health. The latest research suggests that the most positive physical effects of exercise occur at the low-impact, low-intensity level rather than at the high-impact, high-intensity level. The aerobically fit employee has a lower resting heart rate, lower blood pressure, lowered stress-reactivity, and, when combined with flexibility and weight training, improved muscular flexibility and tone. Psychologically, exercise lowers anxiety, helps to metabolize anger and other potentially toxic emotions, and improves mental acuity. Thus employees’ overall physical and psychological health improves.
Jim Loehr and Tony Schwartz have found that adopting some of the lessons from high-performance athletes by corporate executives and employees can enhance health, well-being, and performance. A central tenet in their approach is the management of energy in contrast to the management of time. Thus employee engagement in work and nonwork activities is balanced by strategic disengagement, during which time energy recovery occurs. Balancing energy expenditure in productive activities, on or off the job, with energy recovery through personal renewal activities, leads to both improved health and improved performance. These benefit both the individual and the organization while contributing to sustained energy for longer term career progress and success.
Wellness and fitness programs have been shown to lead to health care cost avoidance. Johnson & Johnson pioneered the approach to health care cost reduction through their health and fitness programs in the J&J family of companies. Because wellness and fitness programs take a systemic view of health, they can lead to overall health improvements in employees, thus reducing a range of health costs for physical, psychological, and behavioral disorders and problems.
Wellness and fitness programs have broad, positive effects throughout a workforce even for the nonparticipating employees. This appears to be due to an osmotic effect that occurs as some nonparticipating employees begin to model the positive health attitudes, behaviors, and actions of the wellness and fitness program participants. This overall improvement in workforce health has positive effects on work attendance and retention while leading to reduced absenteeism and turnover. In addition, overall physical and psychological fitness has been associated with reduced injury rates on the job, which continues as a serious workplace problem for both men and women.
Finally, the net effect of wellness and fitness programs can lead to high performance on the job, coupled with high morale on the part of employees. This is good for individual employees, for their careers, and for the organization as a whole. Thus improved individual employee health has positive effects on organizational health and vitality. The caveat is that wellness and fitness programs should not be aimed at improving employee health and well-being as an intermediate step to increasing work pressures and demands on employees. As stated earlier, in addition to the utilitarian reasons for health concerns at work are humanitarian reasons.
Employer-Sponsored Program Success Factors
If employer-sponsored wellness and fitness programs are to be successful, a number of factors should be considered by management. These program success factors include, but are not necessarily limited to, (a) top management commitment, (b) program goals and objectives, (c) a quality staff of wellness and fitness professionals, (d) appropriate recruitment of participants, and (e) a feedback and evaluation strategy for the program.
Top management commitment to wellness and fitness is essential to the success of any program, as is the case for almost all employer-sponsored programs of any kind. This may mean that senior executives actively participate in the program, as is the case for PepsiCo Chairman and CEO Steven Reinemund, who considers wellness and fitness essential components of leadership development. Alternatively, senior executives provide the resources and other support elements to ensure the success of the program.
Because employees, supervisors, professional staff, and senior management may have different motivations, agendas, and perspectives on wellness and fitness, it is important to use a multidisciplinary approach to the articulation of program goals and objectives. This planning component of the program serves as an important element of feedback and evaluation of the program.
A quality staff of professionals is a third program success factor. This staff may well need to be multidisciplinary in nature so as to include professional expertise in exercise science, behavioral psychology, medical health, risk management, and even social work.
The recruitment of appropriate program participants is a fourth key to success. Early program participants are the leading edge of embedding the program successfully within the organization. Thus influence leaders in the company, to include senior executives, can be very influential in both attracting other participants as well as effecting positive health behaviors more broadly throughout the organization.
Finally, yet critically, it is important to have a systematic feedback and evaluation strategy for the wellness and fitness program. This strategy begins in the planning stage of the program with a clear statement of program goals and objectives. The strategy should include the systematic collection and evaluation of both quantitative data (e.g., percentage of workforce participating) and qualitative data (e.g., participant description of benefits, such as personally, professionally, and for career enhancement).
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