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Wellness insights

Results from phase one focus groups

An Integrative Health Institute and Alberta Blue Cross® partnership

Research lead: Lisa Bélanger, PhD, CSEP-CEP

Key learnings

Key learning 1

Wellness is not a concept that is understood in a corporate context.

Key learning 2

Wellness planning needs to involve employees at all levels.

Key learning 3

There is no one-size-fits-all program.

Key learning 4

Wellness strategies should be comprehensive and holistic while prioritizing mental health.

Corporate wellness action plan recommendations

Define wellness

Set a definition of what wellness means to the company, involving a diverse set of voices from all levels of the company.

Create a corporate strategic plan for wellness

Include input from across the organization, develop a strategic wellness plan with well-defined objectives that supports employee wellness and organizational goals.

Leadership training and modelling

Ensure there is understanding and consensus across leadership on what wellness is, its purpose and goals and its importance to the organization.

Company communication plan

Develop a comprehensive communication plan with clear objectives and a variety of tools and tactics to reach diverse employees.

Evaluation

Define what success looks like and make sure evaluation considers feedback from all employees.

Executive summary

Public health issue

Just over a quarter of company health care costs are due to lifestyle-related, modifiable health risks, such as physical activity, stress and blood pressure (O’Donnell et al., 2015). Chronic health conditions are on the rise across all age groups, and these conditions create major sources of lost productivity in the workplace, such as absenteeism and presenteeism, as well as increases in health-related expenses such as medical costs and pharmaceuticals (Anderko et al., 2012, Burton et al., 2006, Goetzel et al., 2008, Loeppke et al., 2007, 2009).

The workplace poses an ideal opportunity to support both individual wellness and the health of the organization. Companies with a strong culture of wellness report better financial outcomes and lower employee turnover than those without (Isaac 2010). In 2003, a comprehensive study focusing on the economic Return on Investment (ROI) of workplace health promotion concluded that workplace programs achieve a 25 to 30 per cent reduction in medical and absenteeism costs over an average of about 3.6 years (Chapman 2003).

Alberta Blue Cross® has prioritized and invested in a comprehensive approach to wellness. Balance®, our online employee wellness program, was launched in 2015. Our team members are empowered with the tools and resources to foster opportunities to adopt healthy behaviour in the areas of wellness that mean the most to them at any given time. At Alberta Blue Cross®, engagement with wellness means leadership buy-in, ensuring ongoing participation through effective communication and awareness of wellness activities offered

We have seen firsthand how a fully integrated wellness program can increase engagement, improve productivity and reduce costs. Despite these benefits, many companies have not yet implemented corporate wellness programs. While experience provides some insight into why companies have failed to implement corporate wellness programs, we initiated this study to challenge our assumptions, to validate our approach and to demonstrate the efficacy of our solutions.

Purpose of research

  1. To explore the factors that promote and inhibit the uptake and implementation of wellness programs within organizations.
  2. To strengthen current knowledge and understanding around the relationship of health and productivity, as well as the cost-benefit of wellness initiatives within the workplace.

COVID-19 and this study

No one could have predicted the impact COVID-19 would have on individuals, communities and companies. Facing and adapting to the pandemic has validated and deepened our understanding of the study’s findings. From the onset, one finding was clear: having an established and respected employee wellness culture prior to the pandemic significantly supported our organization’s stability during the crisis by allowing us to quickly adapt wellness programs and offerings to meet employees’ changing needs and work environments. The knowledge gained and actions taken related to our experience with COVID-19 are highlighted throughout the report in sections labelled A COVID-19 perspective.

“Non-thriving cultures are 10 times more likely to suffer in a crisis than thriving cultures.”

2021 Global Culture Study, O.C. Tanner Institute

Methodology

Focus groups were chosen for data collection to gather in-depth information from a variety of perspectives in response to exploratory research questions. Eight focus groups were interviewed with each group consisting of five or six employees from the same company.

Participants consisted of employees of various positions from small- to mid-size Albertan companies. Companies were chosen carefully to ensure equal representation of both those that have successfully implemented a corporate health and wellness program and those that have not.

A semi-structured questioning route was used to moderate the focus group. The questions included opening, introductory, transition, key and ending questions. Each focus group session was audio recorded and transcribed verbatim to document the participants’ verbal responses. Once the data were sorted into topics, direction and compared against ideals, the data was analyzed to identify potential recommendations for implementation of a successful program.

Key learnings

Through close examination of the study findings and participants’ responses, four key learnings have been identified. In addition to these learnings, we have included the significant facilitators and barriers related to the learning as identified in the results and discovered through our own wellness implementation experience at Alberta Blue Cross®.

Key learning 1

Wellness is not a concept that is understood in a corporate context.

The focus groups were familiar with what employer health benefits are and whether their organization had them. However, many of the focus groups were unfamiliar with wellness programs in general or if their company had one. From these findings, we inferred that employees need to be educated on the definition and purpose of wellness before engaging in wellness activities. The desired outcomes and the link between wellness and company strategy must also be communicated

Barriers
  • Lack of an understanding of wellness, workplace culture and corporate wellness.
  • Lack of a clear communication strategy to educate and engage employees in existing wellness programs and their role as ambassadors in the organization.
  • No baseline data to determine information gaps that employers can address with their employees.
  • Employees see wellness as something being done to them rather than something they are a part of.
  • Senior leaders are not clear or aligned on the purpose of wellness as an integrated part of their organization.
Facilitators
  • Varied communication content and methods to reach and influence a diversity of employees.
  • A wellness strategy that clearly communicates the link between wellness and company goals.
  • Company leaders modelling wellness behaviours, supporting a wellness-focused organization and clearly defining what wellness is and the outcomes to be achieved.
A COVID-19 perspective

While Alberta Blue Cross® had an established wellness program before the pandemic, it was important to ask what does corporate wellness mean for our employees amidst a pandemic? As per key learning one, we needed to not only quickly rethink the meaning of wellness but look at new ways to communicate and engage our employees on the topic

Leveraging our established wellness theme Better Together, we built a wellness campaign specifically targeting pandemic issues: self-care, tips and tricks, stress management, health care and even online counselling were made available. Specific COVID-19 resources and supports were added to Balance®, our online wellness platform. We then focused on ways to inform our team members about the new resources and wellness priorities. We shared ongoing communications through weekly employee emails from the executive team and posted updates on the company intranet to inform employees of events, campaigns, resources and supports.

Noteworthy are the weekly phone in town halls, where our CEO shared organizational priorities during this time, the first and foremost being the care and well-being of our employees through this transition and doing whatever it takes as an organization to support employee well-being.

Key learning 2

Wellness planning needs to involve employees at all levels.

A successful wellness strategy depends on input and engagement from all levels within the organization. Employee input is vital to the long-term success of a wellness program. The earlier employees are involved in the development of the program, the more likely they are to engage. Leadership must actively show buy-in by modelling wellness behaviours to encourage adherence from the rest of the organization and develop a wellness champion mindset in everyone.

Barriers
  • Top-down approach to communications.
  • Lack of buy-in from leadership.
  • Lack of a communications strategy.
  • Communications methods used are inappropriate or don’t reach the audience.
  • Employees don’t feel empowered or like they have permission to focus on wellness.
  • No opportunity for employee feedback through focus groups, surveys or other methods.
Facilitators
  • Regular review and evaluation of wellness strategy to ensure employee needs are being met.
  • Time and expertise dedicated to developing wellness programming.
  • A wellness champion culture where everyone feels they are part of the wellness ecosystem.
A COVID-19 perspective

At the best of times, two-way communication can be difficult to foster. With 98 per cent of Alberta Blue Cross® team members working from home, impromptu drop-ins and face-to-to-face checkins were no longer a possibility. At the same time, with mounting anxieties and feelings of isolation, employee feedback and two-way communication was even more critical.

Departmental surveys focused on wellness were made available to ensure all team members had the opportunity to share feedback. The aggregate feedback was shared with managers so they could champion and resource accordingly to meet the needs of their teams. By better understanding what was working and not working well as we transitioned to work from home, mangers could be part of the resolution rather than recycling ongoing problems and inefficiencies

Virtual mental health booster sessions were made available for managers. These sessions not only supported their well-being but helped them foster positive and productive team member check-ins so they felt heard. In this fashion, all team members were provided with adequate supports and resources. Suggestions from these initiatives were brought to relevant internal stakeholders to start conversations around change management, resourcing, necessary supports and more.

Key learning 3

There is no one-size-fits-all program.

Wellness strategies must be tailored to the needs, concerns and lifestyles of employees. Programs need to be accessible and adaptable to different work styles, such as work-from-home, part-time and seasonal. Programs should be varied in activity and topic to meet the health and wellness concerns of employees. Organizations need to consider providing a range of rewards to keep employees engaged and motivated. Along with extrinsic rewards, intrinsic and interpersonal rewards, such as decreased stress, a general sense of well-being and enjoyable social interactions with colleagues, should be considered and made accessible.

Barriers
  • Variable geographies, worksite locations and work types.
  • Employees that are ineligible for benefit or wellness plans due to work type, such as seasonal, hourly, casual or contract workers.
  • Lack of dedicated time for employees to devote to wellness during work hours.
  • Technological limitations including employee familiarity with virtual tools.
  • Abundance of information and confusion on best practices.
  • Unaware of intrinsic and extrinsic behaviour change motivations.
  • Siloed thinking.
Facilitators
  • Input from all employee types when developing strategy and facilitating a variety of wellness programs.
  • Multiple stakeholder input throughout strategic and operational planning.
  • Program flexibility.
  • Fostering intrinsic rewards and a culture of inclusivity.
  • Established vehicles for education, information and ongoing communication.
  • Change management considerations.
A COVID-19 perspective

With the adoption of working from home, it was important to support team members who had less virtual experience. Our wellness department worked closely with internal teams to provide feedback on relevant training needs, such as WebEx, OneNote, staying organized and how to utilize change management techniques to ensure smooth transitions. Providing training on how to navigate a virtual environment and related platforms like Zoom and WebEx helped mitigate fear and increase engagement not only in wellness programing but work in general.

Understanding the benefit and reward of social activities, existing in-person social groups were moved to virtual platforms. For example, our games group and Spanish club are now virtual. However, understanding that virtual platforms cannot completely replace in-person connection, we developed several socially distanced friendly events for individuals to participate in such as outdoor walks.

Key learning 4

Wellness strategies should be comprehensive and holistic while prioritizing mental health.

Wellness initiatives focused on a single aspect of wellness are less likely to make an impact. The most successful wellness programs should address physical, social, financial and mental well-being. It is important to note that without addressing mental health, the other health-promoting behaviours are likely to be neglected. Corporate wellness strategies should make mental well-being a primary target as employees are unlikely to partake in other wellness strategies if they are suffering from mental health issues, such as burnout, anxiety, lack of support, no access to adequate resources or stigma related to mental health.

Barriers
  • Lack of understanding about holistic wellness and how mental health, financial health, physical health and social engagement impact each other.
  • Lack of a framework to understand where, why and how wellness fits in a larger ecosystem to include strategy, operations, communications, metrics and environment.
  • Stigma associated with mental illness.
  • Unaware of supports and resources available.
  • Focusing too much on treatment versus prevention.
Facilitators
  • Good work-life balance.
  • Open and safe communication.
  • Ensure mental health is a key pillar in a comprehensive wellness strategy.
  • Provide mental health training for all employees.
  • Ongoing campaigns and communications strategies that reinforce a company’s message and how they support mental health.
  • Partnerships with other provincial and government organizations that can support mental health.
A COVID-19 perspective

To continue the success of our wellness programing during the pandemic, it was imperative that we address the emerging needs and concerns of our teams. Existing educational sessions, such as nutrition and psychology lunch and learns and financial oneon-one sessions, were made virtual and COVID-19 related materials including health tips and coping with stress were accessible online. We continue to add resources and tools with the understanding that employees across the organization require different types and levels of support as we continue to navigate through this unprecedented time.

Prior to COVID-19 Alberta Blue Cross® had placed a priority on mental health. In late 2018, Alberta Blue Cross® leadership made mental health training mandatory for all team members with training beginning in 2019. This high prioritization of mental health support in the workplace continued in 2020 with six sessions of Mental Health Commission of Canada’s The Working Mind training in the first quarter—bringing the total portion of Alberta Blue Cross® team members trained to over 80 per cent. Further training was impacted by COVID-19; however, with new virtual options now available, we will begin offering additional training sessions in early 2021 and ongoing as part of our new employee onboarding plan. With the added stress and anxiety of the pandemic, the mental health of our employees became even more important. As stated previously, we have an open invitation to all managers for 20-minute mental health booster training sessions to provide continued support, information and updates. We partnered with outside resources to provide additional mental health resources such as text4hope and free access to Stronger Minds by Beacon® an online mental health portal. Through ongoing partnership with our communications team, we are developing a communications strategy that reinforces our commitment to mental health and supports.

The study

Integrative Health Insitute

In September 2014, the University of Alberta established the Integrative Health Institute (IHI), an interdisciplinary and inter-faculty institute. In March 2015, IHI developed partnerships with the Universities of Calgary and Lethbridge as well as Alberta Health Services. Our common interest is research and education to inform policy and practice. IHI also has partnerships with leading organizations in China, India and the United States.

Vision

Optimal health and well-being by integrating conventional, complementary and traditional approaches.

Mission

Research and education to advance health and inform choice.

Integrative health is an emerging concept that is helping to re-shape the way society thinks about disease prevention and health promotion as well as chronic disease management and resiliency. It is the foundational concept for IHI. With more than 120 scholars from 14 faculties participating, IHI encompasses tremendous breadth and depth of expertise, spanning basic science, clinical and health systems, as well as social, cultural and population health research.

Lisa Bélanger, PhD, CSEP-CEP


Dr. Bélanger is the CEO and founder of ConsciousWorks, a consulting firm that contributes to research and research-based programming on community and workplace wellness around the world with a specific focus on leadership and health behaviours.

Dr. Belanger has a PhD in behaviour change and is also a certified exercise physiologist; a past honorary research associate at Swansea University, Wales; a researcher and instructor at the University of Calgary; an instructor at the University of Alberta’s Executive Education program; and the author of Inspire Me Well: Finding Motivation to Take Control of Your Cabin, a national on-profit offering no-cost wellness programming to cancer survivors.

Background

Just over a quarter of company health care costs are due to modifiable, lifestyle-related health risks such as physical activity, stress and blood pressure (O’Donnell et al., 2015). Chronic health conditions are on the rise across all age groups. These conditions create major sources of lost productivity in the workplace (Loeppke et al., 2007) and increase health-related expenses in both direct medical payments and indirect costs from absenteeism and presenteeism (Anderko et al., 2012, Burton et al., 2006, Goetzel et al., 2008, Loeppke et al., 2009). One suggestion to help alleviate health-related costs and improve company performance is to invest in corporate health and wellness programs. But do these programs work?

Extensive evidence indicates that well-designed, evidence-based health and wellness programs within a supportive culture are successful at

  • decreasing health care-related costs for the company and the employees (Naydeck et al., 2008),
  • increasing employee productivity (Mitchell et al. 2013, Lerner et al. 2009),
  • improving health-related outcomes,
  • changing lifestyle behaviours (Mattke et al. 2013),
  • lowering employee turnover (Isaac 2010), and
  • improving overall economic performance of the company (Goetzel et al. 2019, Isaac 2010).

Despite these benefits, many companies have not yet implemented corporate wellness programs. As stated in the executive summary, Alberta Blue Cross® has a long history of implementing wellness programing both internally and supporting other organizations. Overtime, we have developed insights on the benefits of a wellness program to an organization, as well as the barriers and facilitators companies face when adopting or implementing a wellness program of their own. This study was commissioned to build upon learnings and challenge the assumptions we have garnered over time. This will allow us to improve the wellness of Alberta Blue Cross® team members, but help us support our customers in developing their own wellness programs.


Purpose

This study has two main purposes:

  1. to look at the factors that promote and inhibit the implementation and uptake of wellness programs within organizations; and
  2. to strengthen current knowledge and understanding of the relationship between health and productivity, as well as the cost-benefit ratio of wellness initiatives within the workplace.

Methods

Participants

Study participants were purposefully chosen from leadership, human resource professionals and employees from small- to mid-size Alberta companies. The aim was to have equal representation between companies that have successfully implemented corporate health and wellness programs and those that have not. Companies were initially invited to participate by their health benefits provider, and all subsequent communication with study participants was through members of the research team. Ethics approval was obtained from the University of Alberta Human Research Ethics Board.

Data collection and analysis

Focus groups were chosen for data collection for this study as they allow collection of in-depth information from a variety of perspectives in response to exploratory research questions.

Focus groups were particularly useful in this study because participants were asked to discuss the complex nature of health and wellness programs within their companies (Gill et al., 2008).

Participants were emailed informed consent forms prior to the focus groups. At the beginning of the focus group, participant consent forms were collected, and participants were provided with a verbal explanation of the study with opportunity to ask questions.

Eight focus groups were conducted, each with five or six participants from the same organization. Once the data were sorted into topics, direction (negative or positive) and compared against ideals, the data were analyzed to identify potential recommendations for implementing a successful program. Multiple potential recommendations per participant were identified in each of the focus groups, so the recommendations were grouped whenever possible. Recommendations were contextual to the organization, making the development of a singular solution challenging. The researcher also flagged specific suggestions for implementing recommendations.


Results

Awareness of corporate wellness initiatives

Lack of awareness was common when participants were asked about their current wellness program, most often because their companies did not have a wellness program or participants were unsure if their company had one. This is highlighted in the below comments:

“I’m actually not familiar with the corporate wellness structure here, I don’t know whether we have one. I know we defer to Alberta Blue Cross® as a benefits provider, but I don’t necessarily know that we’ve got a structure.”

-Study participant

“I don’t have much experience with a company that has a well-developed wellness program—benefits, health—yes—but not necessarily on a wellness side.”

-Study participant

Tailoring communication, not just in content but in delivery methods, was also highlighted. How do employees obtain information? Are they reading emails? Checking Facebook? Reading notices on a board?

Recommendations

Clear communications to all employees regarding wellness are required on a regular basis. These communications should

  • define what wellness is and why it is important both to employees and to the organization;
  • delineate wellness into areas of focus for the organization (such as physical wellness, financial wellness, social wellness, mental health);
  • identify the company’s and leadership’s commitment to employee health and wellness; and,
  • identify existing resources employees can utilize to improve their health and wellness.

Input and engagement

Input from all levels is necessary for a successful wellness strategy. Focus group participants agreed that the best place to start is to have an organizational strategy for wellness. Communication about a wellness strategy and program is paramount both in terms of advertising offerings, as well as the ability for employees to provide feedback on the offerings. If decisions about a wellness program are made without employee input, it is less likely to get uptake among employees and will therefore be less successful.

“Sometimes I think we come out with this nicely packaged little thing and we say to employees ‘here’s our new wellness program’. And they go ‘wait a minute, we didn’t even tell you what we needed and you’re telling us what we need.’ So I think there has to be that opportunity at least for people to have input. If they choose not to, that’s on them.”

-Study participant

“I also think staff need to buy in because it doesn’t matter what managers or the organization are supporting; if staff don’t think that’s meeting their needs, then there’s no point. I think it all sort of has to meet in the middle in terms of direction, funding, support and actually what the wellness activities are.”

-Study participant

The majority of the focus groups agreed that the leadership needed to not only buy into wellness programs, but also be able to influence and model behaviours in order to achieve higher adherence from the rest of the organization.

“The health and wellness piece needs to be built into the leadership development because what that demonstrates to the staff is that the executive level at the organization is standing behind and promoting what they’re doing, because that’s huge.”

-Study participant

“So really, the employee has to know that it’s not because they have a boss that the rules in their department are different, if that is what our corporate direction is. The consequences have to be applied fairly and consistently.”

-Study participant

Constant evaluation of wellness programs and being open to feedback were also mentioned as being highly important.

“I think we need to constantly visit it to say ‘well, is it working? Is it right for the organization today? What do we need to do for tomorrow? What trends are we seeing across other workplaces or other industries that are creeping up that we might need to pay attention to?’”

-Study participant

Recommendations:

  • Create a company wellness strategy that
    • aids in information program development and increases buy-in;
    • ensures the program is linked back to the purpose and direction of the organization; and
    • collects input from the all levels of employees, which aids in program design, employee participation and improving outcomes.
  • Offer the opportunity for employee feedback and measurement of program effectiveness.
    • Offer the opportunity to make necessary changes to improve programs and for financial investment of the company and time or financial investment of employees.
  • Offer education to leaders on how they can support and model the wellness programs to increase program participation.

No one size fits all

Focus group participants expressed that it would be difficult for large organizations with a diverse workforce to adopt a wellness program. They agreed that all employees deserved wellness activities, but that employees would rarely benefit equally from them. Several focus groups recognized that many employees (seasonal, hourly, casual, contract, etc.) do not qualify to participate in any benefit plans, even though they play an integral role in the organization. In terms of flexibility, they questioned what could be offered to those who do not qualify for regular benefits. Participants expressed that any attempt by an organization to organize events or activities without considering employee needs was pointless.

“You’ll get a few people who are genuinely interested in that, and the rest will be like ‘whatever, doesn’t work for me, there it is again, they’re not looking for my needs, they’re just saying oh we have a walking club, check a box.’”

-Study participant

“So having something flexible … You know, something that works for the contract and not something that works for the administration people. Just being flexible and doing what makes sense, there’s no point in having a policy that people can’t take advantage of.”

-Study participant

Recommendations:

  • Personalize wellness program offerings to employees, their needs and their lifestyles.
  • If there are different generations and working structures (shift work, contract, seasonal, etc.), consider offering a variety of options to maximize impact.

Whole health

A greater ability to balance work and life would increase wellness overall. Wellness initiatives solely focusing on either monetary contributions or activities related to a single aspect of wellness were unlikely to make much of an impact on employee wellness.

Several groups mentioned that people were already overworked, overburdened and not taking their breaks, so it would be unlikely that they would take part in wellness strategies (such as going to the gym at lunch), even if it was encouraged or paid for by the organization.

“When they focus on one area of health and wellness in terms of ‘we’re just going to do this one thing’ and neglect other things, like workload or stresses or whatever, it doesn’t feel very genuine, it has to be a true rebranding that looks at all aspects of being an employee.”

-Study participant

A COVID-19 perspective

As stated in the summary we would be remiss if we didn’t acknowledge the impact COVID-19 has had on our people and organization and how it has impacted our understanding of the findings of the study.

As our organization adapted and transitioned to meet the challenges of the pandemic the learning from the study took on new meaning and significance. Perhaps most significant was how having a well-established internal wellness program in advance of the pandemic provided organizational stability during the pandemic. Through existing wellness channels, we were able to provide important COVID-19 information and resources to employees in a timely and efficient manner.

In early 2020, Better Together was chosen as our wellness theme based on internal conversations, DECEMBER 2020 16 evaluations and awareness of the need for social engagement and the power of unity and collaboration. Better Together became even more apt moving into COVID-19 when within one week, 98 per cent of Alberta Blue Cross® team members started working from home, facing unanticipated stressors such as isolation, loneliness, economic uncertainty and fear of the unknown. It was important that our consistent messaging stated that we are in this together, no matter what.

First, the internal wellness team adjusted priorities to deliver virtual resources in a timely manner by working closely with other internal teams to develop virtual resources and remote access. Leveraging our theme, we then began introducing new virtual wellness tools to team members for continued accessibility and to support our efforts to keep our people well.

When implementing any program, it is important to consider the experience, knowledge and skill level of all employees. While some of our team members were already familiar and comfortable with online tools, we quickly realized that others would require training to access virtual wellness supports and perform regular work duties during the pandemic. Providing different options to access materials and training on how to use the platforms helped mitigate fear and increase engagement. Wellness programs and updates were provided through multiple vehicles, including online live sessions, videos, blogs and through regular phone-in town hall sessions.

“Your team is so inspiring, so thank you all for giving everyone the opportunity of wellness in every way!”

-Alberta Blue Cross® team member

As the study results showed, wellness programing must be relevant to individuals’ needs and concerns. Wellness concerns shift dramatically during a crisis like the COVID-19 pandemic, making it important to shift wellness content to meet the new and overwhelming concerns of employees. Building a wellness campaign specifically targeting pandemic issues, such as self-care, tips and tricks, health care and even online counselling, allowed Alberta Blue Cross® to support our people, plan members and all Albertans. Specific COVID-19-friendly resources and supports were added to the Balance® platform for internal team members and clients. New materials and regular updates were provided to our teams through a variety of virtual channels as the pandemic situation evolved. We also increased efforts to support Albertan’s health by offering wellness videos and blogs on social media as well as supporting unique programs such as text4hope, free access to Stronger Minds by Beacon.

“I am really appreciating the change in content from the wellness team. Wellness videos, comedy corner, virtual meditation, wellness break challenges, etc. I think you have handled the work-from-home shift very well.”

-Alberta Blue Cross® team member

“…thanks to you and the rest of the wellness team for continuing to provide great speakers and topics to improve wellness across the company!”

-Alberta Blue Cross® team member

Leadership buy-in is vital to the success of any wellness program. This is even more true during times of organizational uncertainty and change such as the pandemic. Alberta Blue Cross® team members had access to leadership through weekly phone-in townhall sessions where leadership would provide current information. They were also able to submit anonymous questions before the meeting and we are currently piloting a tool to allow live questions.

“I wanted to take a quick minute to thank you and the entire executive committee for all that you are doing to ensure we are safe. I feel blessed to be part of a company that is looking after our wellness and health.”

-Alberta Blue Cross® team member

Pre-existing emphasis on mental health prior to COVID-19 undoubtedly fostered the emotional intelligence and healthy language individuals needed to discuss concerns in the unfolding situation. The second and third quarters of 2020 presented opportunities to evaluate and assess the ways in which our Alberta Blue Cross® culture of wellness helped us sustain team member engagement, disseminating information and providing access to key resources during the pandemic.

Throughout the study, social activities were identified as one of the top rewards identified by participants and an important part of employee wellness. However, moving 98 per cent of team members to work from home and maintaining social distance requirements meant staff events, impromptu or planned, was no longer an option. At the same time, finding ways to keep coworkers connected socially became even more important as we faced mental health issues related to isolation. It was imperative to find new ways to provide social interactions. As much as possible, we have transitioned existing social groups to virtual platforms. However, virtual platforms cannot wholly replace in-person connection. As a result, we developed several regular socially distanced friendly events for everyone to participate in.

“The walk last night was wonderful, a well-needed catch up with co-workers, walking on a beautiful evening. These walks are a great idea, I hope they continue into the fall possibly even winter, weather permitting.”

-Alberta Blue Cross® team member

“Live session was great! The wellness breaks are probably the biggest thing I miss from being physically at work.”

-Alberta Blue Cross® team member

Significant work done in response to COVID-19 aligned with the existing internal roadmap. For example, projects planned for the latter half of 2020, such as wellness supports for work-from-home team members, became immediately relevant, and their early execution allowed for unanticipated expansion and improvement in future quarters.

Furthermore, the internal wellness team is prepared to leverage positive changes in our return to on-site work and how this can be addressed from a wellness perspective. Specifically, increased comfort with using virtual technology widens the potential for robust wellness offerings now and in the future, such as enhanced on-demand wellness break resources.

Further discussion

Important points to consider for corporate wellness programs.

Mental well-being

Mental well-being predominated the conversations across all focus groups. Leaders and employees alike would like more information and training on stress management, crisis management and how to support the mental well-being of others. Without addressing mental well-being, the other health-promoting behaviours seem to be neglected. In fact, there was little to no mention of behaviours such as nutrition, physical activity and sleep. There was no mention of chronic disease management. The focus on mental well-being offers possibilities for both programming and implementing how health-promoting behaviours affect mental well-being and stress.

Time

Time is the number one reason people of all walks of life fail to engage in health-promoting behaviours (Kelly et al. 2016). Study focus groups were no different. If an organization is asking for time investment during or outside of work hours, the case must be clear on why. A focus on enjoyment and socializing can enhance participation.

Wellness program suggestions
No or low cost
  • Referring employees to free sources that already exist (apps for mental health and meditation, free online exercise and nutrition resources).
  • Working with partner organizations (such as an organization offering animal therapy).
  • Break and workday flexibility—being able to stagger work hours and breaks when possible.
  • Organizing social events and lunch-hour activities that open opportunities for interaction and building social relationships with co-workers.
  • Employee acknowledgment and recognition, such as small tokens of appreciation, cards saying good job and gift cards.
  • Workplace flexibility—allowing employees to work from home or other places of choice, when possible.
Cost
  • Optimized office spaces, such as ergonomic furniture, staff room/kitchen, sufficient lighting and plants.
  • Space to shower/change—deterrent to exercise if cleaning up after a run or bike ride is not possible.
  • Paid day for employees to volunteer at an organization of their choice.
  • Lunch and learns—education or training sessions that includes food. Suggested topics are nutrition, caring for aging parents, reading a paystub, money management and reducing stress.
  • Company-organized special events, such as field trips and staff awards with prizes.
  • Mental health awareness and training, especially for leadership.
  • Places to recharge including break rooms and a nap room.
  • A variety of exercise classes organized by organization.
  • Daycare options available on site.

Rewards

Reward systems are often incorporated into corporate wellness programs. Extrinsic rewards were rarely mentioned in any of the focus groups. In discussions, rewards were defined as decreased stress, general sense of well-being and enjoyable social interaction with colleagues. Not only are social relationships key to enhanced work engagement and the short- and long-term health of employees, but social relationships can be used as a reward or incentive for program participation. Consider collaborative approaches to wellness programs over competition for sustainable behaviour change.

Wellness spending

Throughout the focus groups, the most frequently mentioned recommendations for successful implementation was increased flexibility with health and wellness spending including the ability to use health spending accounts for wellness. Participants suggested several low, minimal or indirect cost suggestions, including those requiring direct investment, with food being suggested most often. Most focus groups mentioned how food was an incentive to participate.

Perceived benefits of wellness programs

Focus groups also discussed the benefits of wellness programs and initiatives. The primary perceived benefits of corporate wellness programs that contribute to Return on Investment (ROI) included

  • reduced sick leave and absenteeism,
  • less turnover,
  • increased productivity and efficiency,
  • increased employee satisfaction,
  • increased employee engagement, and
  • increased employee happiness.

Next steps and consideration

Corporate wellness action plan recommendations

1

Define wellness.

Set a definition of what wellness means to the company, involving a diverse set of voices from all levels of the company.

  • What does it encompass?
  • Why is it important to the company?
  • Who are the primary stakeholders?
  • Do you have support from the executive team on direction as well as both inputs and outputs expected with wellness?
  • Have you engaged all departments in defining what wellness means to them, what their most pressing needs are and gaps or areas of concern?
  • Have you chosen a theme to drive an internal wellness strategy?
  • Is it relatable and relevant to your employees?
2

Create a corporate strategic plan for wellness

Include input from across the organization, develop a strategic wellness plan with well-defined objectives that supports employee wellness and organizational goals.

  • Is there participation from a diverse set of employees (working area, pay structure, full/part time, gender and age)?
  • Has an external evaluation (environmental scan) of wellness programs outside the company been performed?
  • Has an internal evaluation of wellness programs inside the company been performed?
  • Have the mission, vision and value statements been established?
  • Have detailed wellness goals of the company been created?
  • Has an operational structure to achieve these goals been developed?
  • Is the strategic wellness plan aligned with the strategic plan of the company and the company’s bottom line?
  • Can the corporate strategic plan for wellness be effectively communicated to all employees?
  • Have you thought about how to build a wellness champion culture where everyone has a role regardless of their department, role and position?
  • Do you have someone who can ensure knowledge translation and engagement is happening to and between all departments?
3

Leadership training and modelling

Ensure there is understanding and consensus across leadership on what wellness is, its purpose and goals and its importance to the organization.

  • What education for leadership would be required to inform on their unique role and influence on the company’s wellness strategy?
  • Is the leadership team taught and supported on how to model the desired behaviours?
  • Is additional training to support employees (such as mental health training) needed for the leadership?
  • How will leadership communicate the value of wellness and the desired outcomes for clarity of vision to all?
4

Company communication plan

Develop a comprehensive communication plan with clear objectives and a variety of tools and tactics to reach diverse employees.

  • What are the most effective ways to disseminate information on corporate wellness strategies in the company? (such as company newsletters, company intranet and staff meetings)
  • Who needs to be involved in the communication plan?
  • Are we reaching all areas and employees of the company?
  • Have we created a measure to ensure maximum awareness of wellness programs?
  • How can you socialize the idea of achieving a wellness-focused culture to all departments?
  • How can you build this message in the recruitment and onboarding, as well as ongoing professional development of potential and current employees?
5

Evaluation

Define what success looks like and make sure evaluation considers feedback from all employees.

  • Are the proposed programs’ impacts being measured based on goals determined in the strategic plan (for example, participation, behavioural change, enjoyment and engagement, healthy outcomes, satisfaction, cost containment and human resources metrics)?
  • Do the measures allow for both positive and negative feedback?
  • Are measures capturing the responses of individuals who participate and those that do not?
  • Has a committee or group of employees been established to review feedback on a consistent basis and make appropriate changes to programs or inform strategy?
  • How are key stakeholders informed of evaluation data and how are refinements executed?

Conclusion

Since launching its first internal wellness program in 2015, Alberta Blue Cross® has adapted, modified and grown the program, building a set of best practices around the implementation of successful wellness programs.

This study was commissioned to build upon learnings and challenge the assumptions we have garnered over time. Providing a deeper understanding of client challenges and successes around workplace wellness solutions supports the development of additional tools, communications and resources that will specifically address the organizational needs identified by Alberta Blue Cross® customers. We understand that not all companies have the resources or experience to develop and release their own comprehensive wellness program. As a result, the information found in this report will not only improve the wellness of Alberta Blue Cross® employees through Balance® and other wellness initiatives, but help drive supports to our customers.

Alberta Blue Cross®

Our wellness background

As referenced in the executive summary, Alberta Blue Cross® has prioritized and invested in a comprehensive wellness culture, which is continually evolving and developing. In 2015, Alberta Blue Cross® launched Balance®, an online employee wellness program. The goal of Balance® was to support the success of employees and the organization by

  1. empowering employees to take charge of their wellness by helping them determine and prioritize healthy behaviour and then to provide credible and engaging health and wellness resources to support them now and into the future; and
  2. establishing a baseline of aggregate organizational health and wellness needs in order to target interventions and education where it is most needed, evaluate the efficacy of those interventions and to continually adapt as needs change.

Balance® was introduced company-wide to all team members, informing them the program was live and ready for them to sign in. However, implementation was not without challenges. It was quickly realized that simply providing wellness resources would not establish long-term engagement. To address this, Alberta Blue Cross® established a diverse group of volunteers from across our organization who selfidentified as leaders in health and wellness promotion. These volunteers were named as wellness champions. This empowered the group to act as drivers of the four pillars of wellness: mental health, financial health, physical health and social engagement. Response to Balance® has been positive, with more than 90 per cent of our team members utilizing the platform year over year. Other successful results include

  • 30 per cent improvement in the dietary risk levels of our team members,
  • 17 per cent improvement in the mental health risk levels of our team members, and
  • 17 per cent improvement in the overall stress risk levels of our team members.

Mental health was identified as a key pillar of wellness by Alberta Blue Cross® when it launched Balance®. As part of this focus, psychological benefits for all team members plans were significantly increased. Internally, the organization committed to providing mental health training to all staff. The goal of the training was to increase awareness around mental health, reduce stigma and help create a culture of support, understanding and empathy that would increase productivity at work as well as enhance the personal lives of our people.

Today and into the future we will adapt and evolve our wellness strategies in order to bring the best possible wellness solutions to our people and customers. We believe that sharing the results of this study will prove a solid foundation for other organizations to begin building their own employee wellness programs and, as industry leaders in health and wellness, we are here to help guide that journey.

How Alberta Blue Cross® can help

We are experts at helping organizations build and implement wellness programs that benefit both employees and your organization: Alberta Blue Cross® provides access to two key resources to assist companies in communicating with their employees:

  1. Healthy Workplace Essentials—this organizational certification program provided by Alberta Blue Cross® is a free, self-directed, step-by-step accreditation available through the Alberta Blue Cross® plan administrator website. It will walk you through how to communicate
    • commitment,
    • policy,
    • education,
    • committee creation,
    • wellness planning,
    • health and wellness metrics,
    • improving awareness,
    • empowerment,
    • corporate culture and environment, and
    • operational improvements.
  2. Online Balance® toolkit—this free wellness toolkit is available on our plan administrator website and includes resources such as
    • Balance® communication posters,
    • email templates for
      • invitation to log into Balance®,
      • Healthy Workplace Essentials milestone achievement celebration, and
      • privacy and confidentiality concerns.
    • PowerPoint presentations,
    • Balance® employee handouts and FAQs,
    • monthly wellness plans, and
    • sample employee survey.

We are continuously exploring and developing new and innovative wellness solutions such as our organizational wellness assessment tool that is currently in product development and will be launched in 2021.

Questions

If interested in speaking with a Wellness expert to help support wellness programs in your organization, please contact wellness@ab.bluecross.ca.

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Appendix

Table 1: Focus group questions

Area of discussion Probe
Introductory questions
  • Please can you tell me your name, your role within your company and your involvement with your corporate health and wellness program?
  • How long have you been involved in the health and wellness program?
  • Have you been involved with the health and wellness programs in any other company or capacity?
Perceptions on Health and Wellness Programming
  • Do you think that your company should invest in corporate health and wellness programs? Probe: Why or why not?
  • What do you think of the current health and wellness program at your company?
Implementation
  • Why did your company adopt the corporate health and wellness program?
  • How is it being implemented? Probe: Information comes from where internally—HR? Senior leaders? Wellness program manager?
  • How do you measure the results of the program?Probe: What are the expected or desired ROI?
  • What would be the ideal ROI for the program?
Perceptions of Influence and facilitators
  • In your opinion, who is most influential in the company for successful engagement in the program? Probe: What influence do employers have? Senior leaders? Employees?
  • What do you deem important to make a corporate health and wellness program a success?
Perceived challenges
  • What have been the challenges to creating a successful health and wellness program?Probe: Where does there need to be more ‘buy in’ for these programs to work?
  • Is there a particular group of employees that are resistant to the programming?
Future directions
  • Ideally, what would the corporate health and wellness program consist of?
  • How would it be supported/facilitated?
  • How would it be implemented?
  • What would contribute to its success?
Other
  • Anything else you would like to note on the topic?
End
  • Thank-you for participating. Do you have anything else you would like to share or ask?