How to Improve Participation in Workplace Wellness Programs

Workplace wellness programs have shifted from being viewed as a novel and advanced approach to supporting employees to being commonplace. In fact, workers are noting access to a wellness program as a key benefit they look for in potential employers. In response, organizations across sectors are becoming increasingly interested in how to implement these programs, what they should include, and whether they will lead to specific outcomes. Given the growing recognition of the significance of employee wellness, providing effective support at work is being discussed more now than ever before.

Naturally, a common question that is often posed is, do workplace wellness programs work? To evaluate this, organizations assess pre- and post-intervention, focusing on biometric screenings and various health-related markers of enhanced wellness (e.g., Merrill et al., 2011). While some wellness programs and resources have led to notable improved outcomes for employees and the organization (e.g., reduced absenteeism, increased retention, and improved productivity), others have not been as successful. With mixed results comes further questioning about whether people are using the offered support. As additional time, energy, resources, and funding are being allocated to workplace wellness initiatives and programs, there is an evident need to consider utilization.

How do employers ensure that their employees will actually utilize the resources and services offered?

Employers frequently consider how to engage and motivate employees to use offered resources. In response, organizations promote the availability of support in more diverse ways, such as through gamification and incentives (Koruda et al., 2016; Lowenstein et al., 2019; Mattke et al., 2015), as well as communications via email, newsletters, etc. Although organizations often feel they are doing everything possible to promote their wellness program or resources (e.g., posting flyers, offering program overview presentations, and including informative materials in benefit-related discussions), they still do not always see these efforts translate to anticipated outcomes. While those are all essential steps in ensuring employees know what is available, organizations frequently overlook the impact of messages that may impede employees' decisions to utilize those support offerings. Improving communication around wellness programs is not a new suggestion. However, many recommendations related to improving communication focus specifically on messages about the program itself and how to access the offered resources (UnitedHealthCare, 2023). In addition to focusing on improved communication about how, when, and where to access available support, organizations need to gain a deeper understanding of the messaging that contributes to employees' perceptions of mental and physical health at work more generally. The messages that employees receive—both implicit and explicit—on a daily basis before a wellness program is even offered are critical to its overall success. But often, companies offer a resource or program without first considering the realities of those internal messages.

A common recommendation for enhancing support-seeking and utilization involves urging leadership to foster a culture that promotes health and wellness at work. However, it is essential to note that this is multifaceted and complex. Simply offering resources is not addressing an organization’s culture. Related discussions about a lack of support utilization also often emphasize the role of stigma in contributing to individuals’ support-seeking decisions. For decades, stigma has been deemed the primary barrier to employees seeking support for mental and behavioral health challenges (see Rutherford et al., 2024; Toth & Dewa, 2014). Essentially, in fear of being stigmatized, people refrain from seeking help or using health-related resources, especially regarding mental health. Leaders often note stigma as a natural barrier and overlook what might be contributing to such stigma.

Communication: A Notable Antecedent to Consider

Stigma is perpetuated through communication: The messages employees send and receive about health and wellness directly contribute to negative attitudes and judgment toward health-related challenges and support-seeking that foster organizational culture. This can hinder perceptions of authentic organizational support. Organizations may be missing a pivotal antecedent to a lack of utilization—internal, day-to-day communication. Perceived organizational support (POS) is a crucial factor impacting employees’ decisions to participate in or seek support from resources offered (Ott-Holland et al., 2017). POS refers to the view that the organization genuinely cares for and is concerned about its employees’ well-being (Eisenberger et al., 1999). So, what contributes to the perception that the organization does or does not genuinely care for the health of its employees? Communication is at the foundation. Messages within the organization are critical in employees' decisions to disclose they are struggling and utilize the resources offered. Regardless of the benefits or resources offered, without first addressing the underlying communication influencing employees' views and disclosure decisions, many employees will continue to avoid seeking support.

For example, a study exploring how the messages first responders receive about mental health from within the agency influence their support-seeking decisions found that when messages about support for health- and wellness-related challenges were inconsistent, that hindered their decisions to use resources offered or seek support (Craw & Miller-Day, 2024). Given the nature of their profession, first responders often feel immense pressure to avoid needing support—to keep moving forward to the next call, shift, etc. These expectations are rooted only in the realities of their work but perhaps more so in messages about being tough or strong, about not needing support. The study found that the messages first responders receive throughout their careers about health and wellness shaped their perspective of available support.

Messages both between peers and from leadership may contradict overarching communication about the availability of support for health and wellness. For example, “You’re good, right" following a traumatic experience can communicate an expectation to be OK and not need support, even when the overarching message at other times is to reach out if needed. Other messages may implicitly say, "There is support if you need it, but you should be fine," or "It is up to you to get help if you need it." Another common inconsistency noted by participants was expressing care for employees and then not matching that with action—for instance, failing to (1) check in with employees regularly, (2) spend time understanding their true needs, and (3) facilitate open conversation about health and wellness consistently without the focus of launching a program or responding to an issue.

Another study that examined employees' perspectives on workplace wellness programs across four different companies found that their view of leadership's support of their health was critical to participation (Hoert et al., 2018). These results again highlight how communication within the organization about health and wellness is foundational to positive views of wellness program utilization. Notably, such communication is needed well before the implementation of a new program.

While organizations might be sending explicit messages about what is available for support, the implicit messages in those day-to-day interactions can be even more powerful. The consistency of follow-ups, check-ins, and regular reiteration that support is available and that the organization genuinely cares about the employees is imperative to the success of any wellness program, resource, or initiative. As such, before implementing a new resource or program, organizations must first explore and gain a better understanding of the messages employees are really receiving about health and wellness at work. Considering how health and wellness are discussed or how related challenges are responded to (i.e., do employees actually receive the support and care promised when struggling?) can help identify where communication needs to be improved in order to enhance POS, which is necessary for building trust and ultimately support-seeking decisions.

Health Essential Reads

Building a Healthy World by Supporting Dignity for All

3 Ways to Navigate an Ultra-Processed World

One key first step is training leadership and emphasizing the value of spending time demonstrating genuine care through relationship maintenance across and within teams. Regardless of how innovative, exciting, or accessible offered resources and programs are, without first determining whether employees feel supported in a true way grounded in effective communication, decisions to use such support will be negatively impacted. Thus, to truly make workplace wellness effective, organizations need to start asking, "What messages are we actually receiving about health and wellness currently?" Waiting until a program is being implemented to communicate effectively about health and wellness internally is likely to impact success.

So, what comes first? Implementing a new wellness program or addressing communication? Organizations must start with enhancing POS through effective communication about health and wellness before seeking buy-in for a new program or resource.