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One size doesn’t fit all: Research shows age, gender and health status influence effectiveness of wellness best practices

Employers who want to lower health care spending and improve productivity will benefit from new research that demonstrates how factors like age, gender and influence the effectiveness of commonly accepted industry best practices.

Over the years, the industry has successfully identified a number of best practices that are associated with optimal program outcomes, as well as the program elements that are most common among high-performing workplace programs; however, there has been little evidence to support that such best practices will predict program success and whether factors like age and gender influence the impact that those best practices have on program outcomes.

Connecting the dots with new data

This recent study from StayWell was published in the April issue of the Journal of Occupational and Environmental Medicine and is titled, “Analyzing Best Practices in Employee Health Management: How Age, Sex, and Program Components Relate to Employee Engagement and Health Outcomes.” The study shows that these industry best practices do not generate the same outcomes for all companies, because factors such as a person’s age, gender and health status will influence how they respond to the best practices.

“The outcomes associated with applying best practices to your workplace health management program have not been well-established,” said Jessica Grossmeier, vice president of research at StayWell and principal investigator on the study. “This study advances our understanding of why best practices don’t produce the same outcomes from one company to the next. More specifically, we found that a person’s age, gender and current health status directly influence how they respond to best-practice program elements as well as how these factors combine to influence overall employee participation and behavior change.”

According to Grossmeier, data from 205,672 participants from 55 different companies were examined, pulling from three StayWell sources: individual demographic and health assessment data, employer use of selected best practices, and individual health coaching participation data. The study examined enrollment in a coaching program, active participation in the program, and behavior change for those enrolled in the program.

The study was designed to more precisely measure the impact of the following best practices on workplace health management outcomes and to account for employee attributes of age, gender and health status:

  • Building strong senior leadership support
  • Providing comprehensive program offerings
  • Offering program delivery choices (e.g., phone, online, or print)
  • Implementing population wide health programs
  • Implementing robust communications
  • Offering benefits-integrated incentives for health assessment participation
  • Supporting programs with onsite staff
  • Integrating data across vendors
  • Offering onsite biometric health screening

Key findings

Results from this study demonstrated that best practices do influence engagement and outcomes, but that all best practices did not have the same degree of influence on all participants, nor did they influence outcomes in the same way. More specifically:

  • In general, females and older individuals were more likely to enroll, but this was not true for all companies.
  • Non-cash incentives, such as a T-shirt or duffel bag for participation in coaching programs actually decreased enrollment in coaching programs.
  • When biometric screenings were offered, older employees were more likely to enroll in coaching programs.
  • While companies that used a non-cash incentive saw lower overall enrollment, offering a cash incentive did not necessarily lead to greater levels of active participation in coaching programs once individuals were enrolled.
  • The use of onsite wellness champion networks improved behavior change for older adults.

“One of the most interesting findings from this study is support for something called ‘The Herd Effect,’ which means people tend to behave like their peers around them,” said Paul Terry, Ph.D., chief science officer for StayWell and lead author on this study. “For example, if a worksite is predominantly male, then male employees will tend to participate or change behaviors in a similar manner to their male co-workers. Women, on the other hand, may be less likely to adopt these same behaviors. However, if a male-dominated company follows best practices, the women may be more likely to buck the majority trend to overcome this herd effect.”

What this means for employers

This research is significant for employers because it underscores the importance of customizing employee health management strategies and best practices to the demographics and established cultural norms of a workplace. In addition, the findings shed light on how employers can leverage different best practices to achieve different program goals based on the demographic makeup of their population, in particular:

  • Best practices do not have the same influence in every work environment. In short, one size does not fit all when it comes to health management programming. Some best practices will influence outcomes more strongly in one organization but not to the same degree in another. Selection and application of specific best practices continues to be more art than science.
  • Be cautious about how incentives are used because they may influence intrinsic motivation and behavior change in different ways for men and women.
  • In female-dominated or gender-balanced workplaces, special strategies may be needed to engage men in coaching programs.
  • Although men are more hesitant to enroll in programs, once they do enroll, they are just as likely to actively engage and they see slightly better outcomes.
  • The use of biometric screenings and a strong wellness champion network may help older employees get into coaching programs and improve their health risks.


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