Wellness Program Participation and its Association With Reduction in Health Risks and Health Care Costs: One University's Story.

PURPOSE: Evaluate if there is a(n): 1) reduction in health risk behaviors and 2) association between health and wellness initiative participation and claims costs decreases overtime. DESIGN: Health risk behavior change consisted of the analysis of pre (2009) - post (2019) measures of health questionnaire participants. The medical and pharmaceutical claims costs evaluation consisted of a time-series (2016-2019) design with a comparison group. SETTING: A large mid-western university with a health system. SAMPLE: The health risk behavior sample ranged from 5215-5399, depending on the variable of interest. The medical and pharmaceutical costs sample used a cohort of participants (participating all 4 years, n=11114) and non-participants (not participating all 4 years, n=4776). INTERVENTION: Comprehensive employee health and well-being initiative. MEASURES/ANALYSIS: McNemar's tests were used to identify bivariate associations between 2009 and 2019 health risks. The claims cost analysis used propensity score matching based on select demographics and linear mixed-effects regression modeling. RESULTS: Results show statistically significant (P > .001) improvements (ranging from -2.1% to -12.5%) in 7 of 8 health risk behaviors. 2016 and 2019 claims costs have a lower statistically significant (P > .001) percent increase for participants (32.6%) compared to non-participants (47.5%). CONCLUSION: Employers, may consider implementing a comprehensive health and wellness program as part of their strategy to assist in health behavior risk reduction and health care cost containment.

Employee Sources of Stress and Their Associations With Absenteeism: Differences by Wage Category.

OBJECTIVE: The aim of this study was to examine the association between sources of stress and self-reported illness- or injury-related absenteeism (SRIRA) across three wage categories among participants in an employee health and well-being program. METHODS: In multivariate analyses, linear regression models were analyzed separately by wage bands (low, <$46,100; moderate, $46,100 to $62,800; high, >$62,800). RESULTS: In the low-wage category, child care concerns are positively associated ( b = 0.5, P = ≤0.05), whereas illness or injury of a loved one is negatively associated ( b = -0.6, P = 0.05) with SRIRA. Personal illness/injury is positively associated with SRIRA across all wage bands (in ascending order of wage bands: b = 4.2, P < 0.001; b = 4.4, P < 0.001; b = 4.1, P < 0.001). CONCLUSION: Results provide evidence that employees in different wage categories experience different home-based stressors, which may impact SRIRA. Employers collecting SRIRA data may be better able to respond to the needs of employees in different wage categories.

Unique Barriers to Workplace Health Promotion Programs by Wage Category: A Qualitative Assessment of Secondary Data.

PURPOSE: To understand barriers around accessing or using workplace health promotion (WHP) programs among workers in different wage categories. APPROACH: We conducted qualitative analysis of responses to three open-ended questions about WHP program participation, collected as part of an existing WHP program evaluation. Setting: A large mid-western university. PARTICIPANTS: Of the 20,000 employees emailed an online survey, 3,212 responded (16.1%). The sample was mostly female (75%), white (79%), and comprised of staff members (84%). The average age was 44 years and 67% had annual incomes <$75,001. METHOD: We used NVivo-12 Plus and two coders to apply Grounded Theory on the open-ended questions and identify emergent themes. RESULTS: Although most respondents were happy with the program, differences across wage categories emerged around time, financial incentives, commute, workload, and organizational policies/support. Employees at all wage levels were enthusiastic about creating a culture of health but needed different cultural supports to do so. For instance, higher-wage workers needed to overcome self-made time constraints, while lower-wage workers needed supervisor support to overcome coverage constraints that prevented participation. CONCLUSION: The unique participation challenges experienced by employees in different wage categories provide justification for WHP programs that can better accommodate the participation barriers of all employees. While some programs may simply require more flexible offerings, supervisors may need to be trained to support and foster healthy environments.

Supporting Employee Health at Work: How Perceptions Differ Across Wage Category.

PURPOSE: This study examines the association between sources of stress and perceptions of organizational and supervisor support for health and well-being. DESIGN: Retrospective, cross-sectional analysis. SETTING: Large university in the mid-western United States. SAMPLE: This study focused on university employees with complete data for all variables (organizational support/N = 19,536; supervisor support/N = 20,287). MEASURES: 2019 socioeconomic and demographic characteristics, count of chronic conditions, sources of stress and perceptions of organizational and supervisor support. ANALYSIS: For the multivariate analyzes, linear regression models were analyzed separately by wage bands (low ≤$46,100; middle >$46,100-$62,800; high >$62,800). RESULTS: For all employees, workplace stressors, including problematic relationships at work and heavy job responsibilities, were negatively associated with perceptions of supervisor and organizational support. In comparison, the most salient home-based stressors were negatively associated with perceptions of supervisor support for the lowest-wage band (the death of a loved one, b = -0.13) and middle-wage band (personal illness or injury, b = -0.09), while the one for the highest-wage band (illness or injury of a loved one, b = 0.07) was positively associated with perceptions of supervisor support. CONCLUSION: Stressful job responsibilities and work relationships are associated with lower perceptions of supervisor and organizational support for health and well-being across all wage bands. Favorable perceived support for personal stressors only among high wage earning employees may suggest a need for improved equity of perceived support for these stressors among lower wage workers.

Stickiness is an empirical pursuit: the case for reframing child mental health.

Everyone wants his or her issue to be sticky these days-to be talked about, get into the news, get in front of influential people, and so forth. However, the concept of stickiness, as put forward by scholars Chip and Dan Heath, is more than a fancy new term for salience. Rather, stickiness is defined in a way that recognizes the last several decades of research in the cognitive and social sciences on how people think about complex social issues. In this article, we argue that stickiness is an empirical pursuit, one that requires an accretion of methods from across the cognitive and social sciences but which, if pursued systematically, can contribute significantly to public understanding. Drawing from the FrameWorks Institute's development of Strategic Frame Analysis, we demonstrate how our methods can be used to pursue stickiness and with what effects. Applying this approach to the issue of child mental health, we demonstrate why approaches that posit resonance or salience are likely to prove ineffective in helping the public to prioritize prevention and treatment for child mental illness or promotion of child mental health.

Science does not speak for itself: translating child development research for the public and its policymakers.

Science has an important role to play in advising policymakers on crafting effective responses to social problems that affect the development of children. This article describes lessons learned from a multiyear, working collaboration among neuroscientists, developmental psychologists, pediatricians, economists, and communications researchers who are engaged in the iterative construction of a core story of development, using simplifying models (i.e., metaphors) such as "brain architecture,""toxic stress," and "serve and return" to explain complex scientific concepts to nonscientists. The aim of this article is to stimulate more systematic, empirical approaches to the task of knowledge transfer and to underscore the need to view the translation of science into policy and practice as an important academic endeavor in its own right.

The trouble with issues: the case for intentional framing.

Although framing as a process is value neutral, since it can be put to any political, commercial, or ideological purpose, this article shows how it can be used to engage Americans in discussions of public life and how it might be improved. By offering readers a deeper understanding of the pictures in people's heads that often prevent engagement in issues, the author roots framing in a long history of social and cognitive science scholarship that has addressed the impact of mass media on democratic participation. This article argues that intentional framing can serve as an essential corrective to patterns of thinking in American culture that often preclude considerations of context, systems, and policies and instead advantage explanations of individual effort and worth.

Lessons from the story of early child development: domain decisions and framing youth development.

This article maintains that effective communications strategy derives from a complex understanding of frame coherence. In particular, this understanding calls for a closer examination of the ways in which the "pictures in people's heads" are activated by exposure to a key arena of frame contestation: the issue domain. Drawing from FrameWorks' research on child development, the authors show that by choosing to align child development with specific domains, advocates may serve to further entrench public thinking in ways that imperil expert policy recommendations. Parallel cautions are drawn for youth issues, with further research from the FrameWorks portfolio. While aligning child and adolescent development with health, workforce, or education may result in further news coverage to those policies, research suggests it may also depress support for those same public policies.

Framing youth issues for public support.

The insights from one state illustrate the challenges of working to shape public will to favor support for out-of-school learning opportunities for youth ages nine to fifteen. With the leadership of the Frameworks Institute, local and national research and refraining concepts were used to develop a strategy to help advocates communicate the value of these learning opportunities in ways the public is less likely to dismiss out of hand. Messages reinforcing the developmental need to practice skills using the illustration of brain architecture and emphasizing the important role of community contribution on future leadership proved to be important aspects of the communication strategy.