Research Findings Journalists Cannot Resist: A Tale of Three Mental Health and Well-Being Studies

Addressing employee mental health needs and fostering organizations that enable thriving has become a priority for most workplace health and well-being initiatives. While mental health issues for the nation were of growing concern before COVID-19, the pandemic amplified concerns about loneliness, burnout and deaths of despair. A recent study that garnered attention from the popular press found that participants of individual-level mental health interventions were no better off than non-participants. This editorial reviews that study, summarizes limitations and beneficial learnings from the research, and argues that organizational factors have been shown to mitigate or amplify the effectiveness of mental health services. Tenets of 'patient-centered care' and the principles behind Total Worker Health® will need to be more broadly embraced so that the voice of employees can better inform workplace well-being strategies and strategic plans.

Protocol for a cluster randomised waitlist-controlled trial of a goal-based behaviour change intervention for employees in workplaces enrolled in health and wellbeing initiatives

Many workplaces offer health and wellbeing initiatives to their staff as recommended by international and national health organisations. Despite their potential, the influence of these initiatives on health behaviour appears limited and evaluations of their effectiveness are rare. In this research, we propose evaluating the effectiveness of an established behaviour change intervention in a new workplace context. The intervention, 'mental contrasting plus implementation intentions', supports staff in achieving their health and wellbeing goals by encouraging them to compare the future with the present and to develop a plan for overcoming anticipated obstacles. We conducted a systematic review that identified only three trials of this intervention in workplaces and all of them were conducted within healthcare organisations. Our research will be the first to evaluate the effectiveness of mental contrasting outside a solely healthcare context. We propose including staff from 60 organisations, 30 in the intervention and 30 in a waitlisted control group. The findings will contribute to a better understanding of how to empower and support staff to improve their health and wellbeing. Trial registration: ISRCTN17828539.

Racial Differences in Perceptions of Genetic Wellness Programs

PURPOSE

Genetic wellness programs (GWPs) are a highly innovative workforce wellness product. Recently marketed to U.S. employers by at least 16 vendors, GWPs take advantage of low-cost DNA sequencing to detect genetic risk factors for an increasing array of diseases. The purpose of this research is to understand perceptions, concerns, and barriers related to GWPs, among employees from Black, White, and Asian backgrounds and different income levels.

APPROACH

Qualitative study with 3 focus groups (FGs).

SETTING

Employees of large high-technology companies (deemed likely early GWP adopters).

RESPONDENTS

21 individuals recruited online through User Interviews.

METHOD

FG guide developed via literature review and landscape analysis, and pre-tested. FGs led by a trained moderator and audio-recorded. Transcripts content analyzed for key themes.

RESULTS

Nearly all respondents saw potential benefits to GWP participation for themselves or their families. However, there were profound differences in perceptions of risks to GWP participation between Black and White/Asian respondents. These differences surfaced in three broad areas: privacy and discrimination risks; family impact risks; and feelings about the employer. Willingness to participate in a GWP also varied between Black employee respondents and White and Asian employee respondents (including low-income White employees). Only 27% of Black employees would participate in GWP, compared to 90% of the other employees.

CONCLUSION

Most employees appear likely to support employer adoption of GWPs. However, Black employees report significant concerns regarding participation. Addressing these concerns through program design would benefit all employees, and could increase trust and uptake of GWPs.

Evaluation of an organisational-level monetary incentive to promote the health and wellbeing of workers in small and medium-sized enterprises: A mixed-methods cluster randomised controlled trial

We conducted an independent evaluation on the effectiveness of an organisational-level monetary incentive to encourage small and medium-sized enterprises (SMEs) to improve employees' health and wellbeing. This was A mixed-methods cluster randomised trial with four arms: high monetary incentive, low monetary incentive, and two no monetary incentive controls (with or without baseline measurements to examine 'reactivity' The consequence of particpant awareness of being studied, and potential impact on participant behavior effects). SMEs with 10-250 staff based in West Midlands, England were eligible. We randomly selected up to 15 employees at baseline and 11 months post-intervention. We elicited employee perceptions of employers' actions to improve health and wellbeing; and employees' self-reported health behaviours and wellbeing. We also interviewed employers and obtained qualitative data. One hundred and fifty-two SMEs were recruited. Baseline assessments were conducted in 85 SMEs in three arms, and endline assessments in 100 SMEs across all four arms. The percentage of employees perceiving "positive action" by their employer increased after intervention (5 percentage points, pp [95% Credible Interval -3, 21] and 3pp [-9, 17], in models for high and low incentive groups). Across six secondary questions about specific issues the results were strongly and consistently positive, especially for the high incentive. This was consistent with qualitative data and quantitative employer interviews. However, there was no evidence of any impact on employee health behaviour or wellbeing outcomes, nor evidence of 'reactivity'. An organisational intervention (a monetary incentive) changed employee perceptions of employer behaviour but did not translate into changes in employees' self-reports of their own health behaviours or wellbeing. Trial registration: AEARCTR-0003420, registration date: 17.10.2018, retrospectively registered (delays in contracts and identfying a suitable trial registry). The authors confirm that there are no ongoing and related trials for this intervention.

External Validity and Worksite Wellness: Lessons From China and Illinois

This editorial describes recent randomized controlled trials of worksite wellness interventions and argues that fidelity to intervention designs should be contingent on careful consideration of internal and external validity. A China based hypertension management study which achieved impressive outcomes across 60 workplaces using a comprehensive approach is contrasted with the traditional wellness practices employed in other randomized controlled trials conducted in America. Why studies with negative findings receive more media and professional scrutiny than studies with positive findings is discussed. Three reasons are posited for why bad is stronger than good when it comes to capturing attention. Adoption of new evidence is discussed along with what health promotion professionals can do to advance best practices by considering adoption as an ongoing process.

Adjudicating Traditional Wellness

There is no consensus definition for “traditional wellness” but in worksite health promotion, it usually means the wellness program is a health assessment and/or health screening offering followed by some educational programs, usually in the physical health domain. Using the term traditional wellness may belie an unawareness about or lack of appreciation for the quality improvement principles that are as applicable to the health of a profession as they are to the growth of an organization. This editorial examines how the use of the term traditional wellness is a reflection on our professional zeitgeist. Five ideas that attempt to explain misunderstandings about differing approaches to worksite health promotion are offered along with 5 ways we may be able to make peace with traditional wellness.