Prevalence and characteristics of campus-based employee wellness programs among United States accredited colleges and universities

Abstract

BACKGROUND:

Employee wellness programs (EWPs) aim to support positive changes in employees’ modifiable behavioral health risk factors for disease prevention and management.

OBJECTIVE:

This study described the prevalence and characteristics of EWPs in US accredited college and university campuses.

METHODS:

Identification of the prevalence of EWPs and programming activities offered in 3039 accredited higher education institutions/campuses, and characteristics of these institutions/campuses were conducted, mainly through searching the institution’s web page.

RESULTS:

Overall, 36%of the institutions/campuses offered EWPs, with a significantly larger percentage of 4-year public colleges/universities providing EWPs and wellness programming activities than the 4-year private colleges/universities and community colleges. When limiting the institutions/campuses to 4-year colleges and universities with at least 500 employees, the percentage of these institutions/campuses offering EWPs increased to 57.7%, which was comparable to the findings in the literature. The percentage of the institutions/campuses offering wellness programming activities ranged from 18.1%for injury prevention and ergonomics to 30.2%for stress management. The percentage of institutions/campuses offering injury prevention and ergonomics was significantly lower than the percentage of institutions/campuses offering other typical wellness activities.

CONCLUSIONS:

The prevalence of EWPs offered in accredited college and university campuses do not meet the national goal of 75%, which was set by Healthy People 2010.

Keywords

Workplace health promotion cross-sectional survey universities health promotion statistics numerical data

1 Introduction

Employee wellness programs (EWPs) or workplace health promotion programs (WHPPs) became increasingly popular in corporate America during the 1980s [1], and were gradually embraced by higher education institutions [2, 3]. The National Compensation Survey (NCS) defines an EWP as a structured plan offering employees two or more of the following programming activities: physical activity and fitness, nutrition education, weight management, smoking cessation, stress management, injury prevention and ergonomics, lifestyle assessment tests, hypertension tests, and periodic physical examinations [4]. EWPs aim to assist positive changes in employees’ modifiable behavioral health risk factors for disease prevention and management, and are intended to improve employees’ health and well-being, increase employees’ work ability and productivity, reduce incidence of employee sickness and absenteeism, and to reduce healthcare costs [5, 6].

Employees (faculty, staff, and administration) working in higher education institutions are exposed to the same health concerns and risks that affect employees of other industries in their workplace. For example, a high percentage of employees in higher education institutions engage in sedentary office activities such as working in front of a computer [7], and have improper dietary intake, unhealthy eating behaviors and habits resulting in overweight or obesity [8]. These employees also experience high levels of stress related to work demands in addition to personal circumstances [9, 10]. Ergonomic injuries or work-related musculoskeletal disorders from repetitive strain of using a computer keyboard and mouse in awkward positions, poor posture during prolonged sitting in front of the computer, falls (slips/trips), and improper use of body mechanics when lifting heavy objects are common [11 –13].Offering EWPs in higher education institutions has the potential to enhance health promotion and disease prevention in this population. In fact, a recent systematic review investigating the effectiveness of EWPs in higher education institutions indicated that more than 75%(13/17) of the reviewed health promotion studies reported that university employees demonstrated improvements in health behaviors such as dietary intake, physical activity, and weight loss after participation in a specific health and wellness program [14]

There have been several national surveys to assess the prevalence of employers offering EWPs [15 –17]. Even though some of these surveys may include higher education institutions, none of them specifically reported the prevalence and characteristics of EWPs in academic settings. Higher education institutions have several characteristics that separate them from other workplace environments related to the support and offering of EWPs. Colleges and universities in general have a strong mission supporting the culture of health and an orientation toward wellness/health promotion and disease prevention for students, faculty and staff [18 –20]. However, implementing EWPs at higher education institutions may be limited by bureaucratic structures and departmental boundaries [21]. Most higher education institutions have adequate physical infrastructure, such as recreation centers/fitness facilities, fitness testing equipment, and space for conducting health promotion activities for students, which can be used by faculty and staff [18]. They also have an existing pool of health and mental health professionals for students; some of these professionals may serve as consultants for implementing EWPs. Similarly, various institutions may have academic programs that train students to provide a wide range of health promotion and wellness-related services such as health education and health professions. Development and implementation of EWPs can be facilitated through engagement from faculty and students in the form of research, community-based education and service learning [19]. On the other hand, higher education institutions often consist of employees with diverse ages, racial, and socioeconomic backgrounds in a wide range of job classifications [22]. Offering EWPs to such a diverse group of employees in the complex academic setting is challenging [21]. Because of the unique workplace culture and environments of higher education institutions, they may differ from other industries in offering EWPs.

Only a handful of surveys were conducted within the last ten years specifically related to the prevalence of EWPs offered in higher education institutions. These surveys were mainly confined to regional areas with small select samples [23], community colleges from one state [24, 25], or responding institutions who are members of a specific organization such as American College Health Association (ACHA), College & University Professional Association for Human Resources (CUPA-HR), or National Collegiate Athletic Association (NCAA) [26 –28]. The CUPA-HR survey is conducted biennially with around 350 responding institutions participating in each of the last 3 cycles; private for-profit institutions were excluded [26]. The ACHA survey included more detailed information related to wellness programming activities and has been conducted three times since 2012, with 182 institutions participating in year 2012, 146 in 2014, and 113 in 2018 [27]. Both surveys included 2-year public and 4-year private and public higher education institutions. The response rate of these two surveys was either low (between around 9.5%and 15%) or unknown which may result in an inaccurate representation of the prevalence of higher education institutions offering EWPs [26, 27].

To date, no published reports described the prevalence of EWPs in accredited higher education institutions nationwide. The purposes of this study were 1) to describe the prevalence and characteristics of the current status of EWPs in accredited colleges and universities, and 2) to explore factors associated with the presence of EWPs in these college and university campuses.

2 Methods

Colleges and universities included in this study were those accredited by one of the six regional accreditors involved in higher education accreditation, or the New York State Board of Regents (NYSBR), and the Commissioner of Education. All these accreditors are recognized by the United States Department of Education (USDE) as accrediting agencies. A list of the college and university campuses located in the US and its five territories was found in the Database of Accredited Postsecondary Institutions and Programs website (https://ope.ed.gov/ACCREDITATION/GetDownLoadFile.aspx) which is compiled by the USDE. From this Database (retrieved in June 2018), 18513 entries (institutions and campuses) met the study inclusion criteria, with 10719 accredited by the North Central Association of Colleges and Schools, the Higher Learning Commission (NCA-HLC), 3421 by the Middle States Commission on Higher Education (MSCHE), 1312 by the New England Association of Schools and Colleges, Commission on Institutions of Higher Education (NEASC-CIHE), 177 by the Northwest Commission on Colleges and Universities (NWCCU), 1939 by the Southern Association of Colleges and Schools (SACS), Commission on Colleges, 907 by the Western Association of Schools and Colleges, Accrediting Commission for Community and Junior Colleges (WASC-ACCJC), and Accrediting Commission for Senior Colleges and Universities (WASC-ACSCU), and 38 by the NYSBR. Institutions were excluded if they were closed (n = 2870) or were no longer recognized by the USDE because their (pre-)accreditation was either voluntarily withdrawn (n = 2216), denied (n = 4), expired (n = 2), or terminated (n = 140). After all the duplicates were removed, the final list contained 3039 unique college and university campuses. A group of 370 duplicated institutions randomly selected from the 4-year state universities (https://en.wikipedia.org/wiki/List_of_state_universities_in_the_United_States) was included in that list to serve as a basis for inter-rater reliability.

2.1 Procedures

Twenty-eight occupational therapy graduate students were responsible for collecting information related to the EWPs of the 3039 institutions/campuses. This assignment is part of requirements for the students’ research class. These 3409 (= 3039 + 370) institutions/campuses were assigned almost evenly among the 28 students. Students were not aware of the duplicated institutions. At an introductory session to this assignment, students received an Excel spreadsheet with the name of each institution/campus and its location (city and state), the name of each of the 28 students and their assigned institutions in the first few columns, and columns of headings related to the data to be collected, along with detailed written instructions on where and how to find the information. Specific information collected from each of these institutions/campuses included age (i.e., year of establishment), type (private vs public), category (2-year college vs 4-year college/university), whether they have (are) a medical school or not, category of research intensity, number of students, number of employees, whether they have an EWP, a recreation center that can be used by employees, a designated outdoor walking trail or not, and types of wellness programming activities offered if they have an EWP. Wellness programming activities included in the Excel spreadsheet for the students to check off for each institution/campus were (1) physical activity and fitness, (2) nutrition education, (3) weight management, (4) smoking cessation, (5) stress management, (6) injury prevention and ergonomics, and (7) health risk/prevention screening.

Background information such as numbers of students and employees (faculty and staff) of a particular institution/campus can be found in the Integrated Postsecondary Education Data System (https://nces.ed.gov/ipeds/), Wikipedia, or by searching the institution web page. Information about the research intensity category and whether the institution has (is) a medical school was found in the following two websites (https://en.wikipedia.org/wiki/List_of_research_universities_in_the_United_States), and (https://en.wikipedia.org/wiki/List_of_medical_schools_in_the_United_States), respectively.

Initially students were instructed to call the human resources department of each institution/campus to inquire whether the institution/campus has an EWP or not, and types of wellness programming activities and services offered. Due to a low response rate, alternative methods including searching online (e.g., Wikipedia and institution web page) and emailing the human resources department were implemented. The inter-rater agreement of the 370 duplicated institutions on the presence/absence of an EWP was 72.3%. When discrepancies were found, the authors conducted an independent search to check the institution’s web page or contacted the institution to find out whether the institution/campus offered an EWP or not, and discrepancies were corrected.

2.2 Data analysis

Responses to the majority of the questions in the survey were in the form of dichotomous values (i.e., present = 1, or absent = 0). There were only 27 2-year (private) junior colleges that were grouped under community college/2-year junior college. Type of institution was re-categorized as community college/2-year junior college, 4-year private college/university, and 4-year public college/university. Research intensity of institutions was classified as low, moderate, high, and very high research activity. In addition, age of the institutions/campuses, number of employees and number of students were categorized into 4 strata using the three quartile cut-off points of their respective data. As a result, the four strata for the age of institutions/campuses were: < 53 yr, 53-85 yr, 86-129 yr, and ≥130 yr. For the number of employees, the four strata were: < 250 employees, 250-499 employees, 500-999 employees, and ≥1000 employees. For the number of students, the four strata were: < 1250 students, 1250-2999 students, 3000-7499 students, and ≥7500 students.

Descriptive statistics (frequency and percentage) were used to describe the prevalence of the institutions/campuses offering EWPs, wellness programming activities and services including recreation centers, and designated outdoor walking trails. Chi-square tests were used to compare the proportion of the three types of institutions in offering EWPs, and wellness programming activities and services. McNemar’s tests were used to compare the distribution of wellness programming activities offered in the sample institutions. To control for inflated type I error rate due to multiple testing, we set the p-value for statistical significance at 0.005.

In addition, comparisons were conducted between the prevalence of higher education institutions/campuses offering EWPs and wellness programming activities and services of the present study and those of the 2018 CUPA-HR and ACHA surveys. It appeared the size of the participating institutions in the CUPA-HR and ACHA survey studies tended to be large. To perform a similar comparison between the data of the 2018 CUPA-HR and ACHA surveys and that of the present study, we included institutions/campuses with at least 500 employees, and excluded all community colleges/2-year junior colleges. The reason for doing so was because about 10%of the responding institutions in the 2018 CUPA-HR survey came from community colleges/2-year junior colleges, but more than 25%of the institutions in the present study were community colleges/2-year junior colleges with at least 500 employees. At the end, we compared the prevalence of EWPs among the 4-year private and public college/university campuses with at least 500 employees of the present study to that of the responding institutions in the 2018 CUPA-HR and ACHA surveys.

To identify variables that would associate with higher education institutions offering an EWP, we used multivariable logistic regression analysis. We fit a multivariable logistic regression model with the EWP as the response variable. Explanatory variables were selected using bivariable analysis to select those to be included in the multivariable model. Those with a p-value of 0.20 or less were considered appropriate candidates [29]. Potential explanatory variables included in the multivariable logistic regression model were number of students, number of employees, age and type of institutions, category of research intensity, and whether the institution/campus has (is) a medical school, a recreation center, and an outdoor walking trail or not. Explanatory variables whose regression coefficients had p-values less than 0.05, two-sided, were considered significantly related to the presence of an EWP in the multivariable logistic regression model. Finally, the relationship between the presence of EWPs in each type of higher education institution and the size of the institution/campus as defined by the number of employees categorized into four strata was investigated using one-way ANOVA. All data analysis was conducted using the Statistics Package for Social Sciences (SPSS) for Windows, version 23 (www.spss.com).

3 Results

Table 1 describes the characteristics of the 3039 accredited college and university campuses. Overall, 36%of the campuses offered EWPs (see Table 2). A significantly larger percentage of the 4-year public colleges/universities (53.5%) than 4-year private colleges/universities (29.4%) and community colleges/2-year junior colleges (26.5%) offered EWPs and wellness programming activities and services (all p-values < 0.001, Fisher’s exact tests). No significant difference was found between the percentage of 4-year private colleges and universities and community colleges/2-year junior colleges that offered EWPs, and wellness programming activities and services.

Table 1
Characteristics of the accredited college and university campuses (n = 3039)

Characteristic Frequency Percent

Type of institutions

Private 1385 45.6

Public 1654 54.4

Category of institutions

Community college 731 24.1

Private 2-year junior college 27 0.9

Four-years public university 923 30.4

Four-years private university 1358 44.7

Medical school 173 5.7

Research intensive university

Low research activity 2630 86.5

Moderate research activity 154 5.1

High research activity 127 4.2

Very high research activity 128 4.2

Number of employees

< 250 789 26.0

250–499 700 23.0

500–999 721 23.7

≥1000 744 24.5

Missing data 85 2.8

Number of students

< 1250 738 24.3

1250–2999 750 24.7

3000–7499 726 23.9

≥7500 753 24.8

Missing data 72 2.4

Age of the institution/campus

< 53 765 25.2

53–85 746 24.5

86–129 779 25.6

≥130 749 24.6

Accreditors

NCA-HLC 1003 33.0

MSCHE 615 16.9

NEASC-CIHE 224 7.4

NWCCU 158 5.2

SACS 805 26.5

WASC 318 10.4

NYSBR 16 0.5

Characteristic	Frequency	Percent
Type of institutions
Private	1385	45.6
Public	1654	54.4
Category of institutions
Community college	731	24.1
Private 2-year junior college	27	0.9
Four-years public university	923	30.4
Four-years private university	1358	44.7
Medical school	173	5.7
Research intensive university
Low research activity	2630	86.5
Moderate research activity	154	5.1
High research activity	127	4.2
Very high research activity	128	4.2
Number of employees
< 250	789	26.0
250–499	700	23.0
500–999	721	23.7
≥1000	744	24.5
Missing data	85	2.8
Number of students
< 1250	738	24.3
1250–2999	750	24.7
3000–7499	726	23.9
≥7500	753	24.8
Missing data	72	2.4
Age of the institution/campus
< 53	765	25.2
53–85	746	24.5
86–129	779	25.6
≥130	749	24.6
Accreditors
NCA-HLC	1003	33.0
MSCHE	615	16.9
NEASC-CIHE	224	7.4
NWCCU	158	5.2
SACS	805	26.5
WASC	318	10.4
NYSBR	16	0.5

Note. NCA-HLC = North Central Association of Colleges and Schools, Higher Learning Commission, MSCHE = Middle States Commission on Higher Education, NEASC-CIHE = New England Association of Schools and Colleges, Commission on Institutions of Higher Education, NWCCU = Northwest Commission on Colleges and Universities, SACS = Southern Association of Colleges and Schools, WASC = Western Association of Schools and Colleges, NYSBR = New York State Board of Regents.

Table 2

Compare wellness programming activities across different types of institutions and with 2018 CUPA-HR and ACHA surveys

Programming activity	All institutions (n = 3039)	Community &2-year junior colleges (n = 758)	Public 4-year institutions (n = 923)	Private 4-year institutions (n = 1358)	4-year institutions ≥500 employees (n = 1095)	2018 CUPA-HR (n = 365) or ACHA (n = 113) surveys
Wellness program	1094 (36.0%)	201 (26.5%)	494 (53.5%)	399 (29.4%)	57.7%	60.0%
Recreation center/fitness facility	1377 (45.3%)	552 (59.8%)	282 (37.2%)	543 (40.0%)	64.7%	63.7%
Outdoor walking trail	686 (22.6%)	112 (14.8%)	316 (34.2%)	258 (19.0%)	35.0%
Physical activity and fitness	914 (30.1%)	190 (25.1%)	398 (42.9%)	328 (24.2%)	47.2%	50.4%
Nutrition education	849 (27.9%)	170 (22.4%)	398 (43.1%)	281 (20.7%)	44.9%
Weight management	858 (28.2%)	177 (23.4%)	391 (42.4%)	290 (21.4%)	44.9%	43.4%
Smoking cessation	898 (29.5%)	203 (26.8%)	401 (43.4%)	294 (21.6%)	43.9%	53.5%
Stress management	917 (30.2%)	198 (26.1%)	395 (42.8%)	324 (23.9%)	45.7%	46.4%
Injury prevention and ergonomics	550 (18.1%)	125 (16.5%)	235 (25.5%)	190 (14.0%)	27.7%	25.5%^a
Health risk/preventive screening	807 (26.6%)	160 (21.1)	363 (39.3%)	284 (20.9%)	41.6%

Note. ^a An average of ergonomics evaluations/program (38.6%) and back injury prevention (12.4%). CUPA-HR = College & University Professional Association for Human Resources, ACHA = American College Health Association. Of the 27 2-year private junior colleges, only three (11%) of them offered employee wellness programs.

The percentage of the higher education institutions/campuses offering wellness programming activities ranged from 18.1%for injury prevention and ergonomics to 30.2%for stress management, with a median of 28.2%(see Table 2). McNemar’s tests revealed that the percentage of institutions/campuses offering injury prevention and ergonomics was significantly lower than the percentage of institutions/campuses offering other typical wellness programming activities (i.e., physical activity and fitness, nutrition education, weight management, smoking cessation, stress management, and health risk/preventive screening, all p-values < 0.001).

The prevalence of EWPs offered by the higher education institutions/campuses in the present study (36%) is much lower than that of the 2018 CUPA-HR study (60%, p < 0.001, Fisher’s exact test). However, when limiting the institutions/campuses to 4-year college and university campuses with at least 500 employees, no significant difference between the percentage of institutions/campuses in the present study and that of the 2018 CUPA-HR and ACHA surveys in offering EWPs, and wellness programming activities and services were found, with all p-values ≥0.05, Fisher’s exact tests.

Multivariable logistic regression analysis revealed that having a larger number of employees (i.e.,≥1000), a recreation center that the employees can use, a designated outdoor trail, having/being a medical school, and type of institutions were the characteristics that were significantly associated with the presence of an EWP in higher education institutions/campuses (see Table 3). Community colleges/2-year junior colleges and 4-year private college or university campuses were 56%and 65%less likely to offer an EWP than 4-year public college or university campuses with odd ratios of 0.56 (95%CI = 0.42–0.75) and 0.65 (95%CI = 0.50–0.85), respectively. When limiting the institutions/campuses to 4-year college and university campuses with at least 500 employees, 4-year private college and university campuses and having/being a medical school were no longer associated with having an EWP in the multivariable regression model.

Table 3

Multivariable logistic regression analysis examining factors that associate with university employee wellness program

Variable	Reference group	Adj OR	95%CI	P-value
Recreation center	No recreation center	13.11	(10.34, 16.62)	0.00
Outdoor trail	No outdoor trail	2.85	(2.23, 3.66)	0.00
Medical school	No medical school	1.84	(1.08, 3.13)	0.02
Community college	4-year public university	0.56	(0.42, 0.75)	0.00
4-year private university	4-year public university	0.65	(0.50, 0.85)	0.00
# of employees
< 250	≥1000	0.29	(0.18, 0.49)	0.00
250–499	≥1000	0.40	(0.26, 0.61)	0.00
500–999	≥1000	0.53	(0.37, 0.75)	0.00
# of students
< 1250	≥7500	0.85	(0.49, 1.46)	0.55
1250–2999	≥7500	1.18	(0.77, 1.80)	0.46
3000–7499	≥7500	1.12	(0.79, 1.58)	0.53
Research intensive institution
Low	Very high	0.56	(0.29, 1.11)	0.10
Moderate	Very high	0.58	(0.27, 1.26)	0.17
High	Very high	1.01	(0.46, 2.22)	0.99
Age of the institution (yr)
< 53	≥130	1.26	(0.90, 1.76)	0.18
53–85	≥130	0.91	(0.66, 1.25)	0.55
86–129	≥130	0.75	(0.56, 1.01)	0.06

Note. Adj OR = adjusted odds ratio.

ANOVAs revealed that the relationship between the presence of EWPs in higher education institutions/campuses and the number of employees varied by the type of institutions. For community colleges, a significant difference in the percentage of institutions offering EWPs existed between the lower end size of institutions (i.e., between < 250 employees and ≥250-499 employees). A larger number of employees was associated with a higher percentage of the institutions offering an EWP. However, further increase in the size of the institutions did not increase the percentage of institutions offering an EWP. This was indicated by no significant difference between institutions with 250–499 employees and 500–999 employees, or between institutions with 500–999 employees and ≥1000 employees in offering EWPs. For 4-year private university campuses, a significant linear trend was observed. With the number of employees increased in each of the 4 strata, a significant increase in the percentage of institutions offering the EWPs was observed. For 4-year public university campuses, a significant difference in the percentage of institutions offering EWPs existed between the upper end size of institutions (i.e., between 500-999 employees and ≥1000 employees). A larger number of employees was associated with a higher percentage of the institutions offering an EWP. However, no significant difference between institutions with < 250 employees and ≥250-499 employees, or between institutions with ≥250-499 employees and 500-999 employees in offering EWPs was observed.

4 Discussion

The findings indicated that more than one-third of the accredited higher education institutions/campuses in the US offered EWPs. A much larger percentage of the 4-year public college and university campuses (53.5%) than 4-year private college and university campuses (29.4%) and community colleges/2-year junior colleges (26.5%) offered EWPs. The percentage of community colleges/2-year junior colleges offering EWPs was comparable to that in the literature [24]. When limiting the institutions/campuses to 4-year college and university campuses with at least 500 employees, the percentage of these institutions/campuses offering EWPs increased to 57.7%, which was comparable to the findings from the 2018 CUPA-HR survey (60%) [26]. In addition, the percentages of these institutions/campuses offered wellness programming activities and services were remarkably similar to the findings from the 2018 ACHA survey [27]. Overall, the prevalence of EWPs offered by the higher education institutions/campuses was similar to those reported in other US worksites (36%in the present study vs 46%in the national survey) [30]. However, the prevalence of EWPs offered in higher education institutions do not meet the national goal of 75%, which was set by Healthy People 2010 [31].

Of the seven wellness programming activities surveyed in this study, a significantly lower percentage of the higher education institutions/campuses offered injury prevention and ergonomics than others, which was consistent with the findings reported in the 2018 ACHA survey [27], and national survey of other industries [30]. Occupational injuries in higher education institutions were common, with frequency of reported incidents ranging from about once every other day with 5400 employees [13], to slightly more than once a day with 11000 employees [12]. Furthermore, work-related musculoskeletal injuries were reported as the most common injury type among all university employees [12, 32]. It is unclear why there were fewer institutions/campuses and workplaces offering this type of wellness programming activity. Future studies should explore this issue.

Results revealed that a larger institution/campus as defined by the number of employees was significantly associated with a higher percentage of the institutions/campuses offering an EWP. This finding was consistent with study results from community colleges [24, 25], and national data that larger workplaces are more likely to have programming activities, environmental and policy supports for EWPs [30].

When analyses were limited to larger institutions/campuses (i.e., at least 500 employees), having a recreation center and an outdoor walking trail, and community colleges, but not 4-year private college and university campuses, or having (being) a medical school, remained significantly associated with the presence of an EWP in the multivariable logistic regression model. Based on these analyses, it seemed the presence of an EWP in community colleges was related to the nature of the community colleges, which was not affected by the size of the institutions once the number of employees exceeded 500. This was confirmed by the no significant change in the percentage of community colleges/2-year junior colleges offering an EWP in each successive institution size beyond the 250-499 employee stratum. Previous studies could not reveal this phenomenon due to the small numbers of community colleges with 500 and more employees in the sample [24, 25]. Future studies should explore the association between demographics and locations of the higher education institutions within each type or category and the presence of an EWP.

4.1 Limitations

It is important to acknowledge that the Database of Accredited Postsecondary Institutions and Programs was by no means comprehensive and up-to-date. Some universities, especially states’ university systems have several campuses (senior, satellite or regional) other than the flagship campus across the state. The unit of analysis in this survey was college and university campuses. It is unclear why some of these accredited campuses were not included in the Database. In addition, some institution’s web pages were outdated in providing employee wellness/health promotion information, and the human resources were not cooperative in providing such information, which may skew the data. Lastly, obtaining accurate information about number of employees and students on each campus was challenging as the staff, especially those of private institutions, were not willing to release such information.

5 Conclusion

The findings indicated that 36%of the institutions/campuses offered EWPs. When limiting the institutions/campuses to 4-year college and university campuses with at least 500 employees, the percentage of these institutions/campuses offering EWPs increased to 57.7%, which was comparable to the findings from the 2018 CUPA-HR survey (60%). However, the prevalence of EWPs offered in higher education institutions do not meet the national goal of 75%, which was set by Healthy People 2010 [31]. Even though work-related musculoskeletal injuries were reported as the most common injury type among all university employees, a significantly fewer institutions/campuses offered injury prevention and ergonomics than other typical wellness programming activities.

Knowing some of the factors associated with offering EWPs in higher education institutions may help university administrators develop plans for adoption and implementation EWPs that are tailored to the unique characteristics of their campus. University administrators may consider leveraging existing infrastructure such as recreation centers, outdoor walking trails, or medical school/health center (i.e., students and faculty of health professional academic programs) when planning to implement an EWP [16, 19]. Given an alarming shortage of programs in the area of employee injury prevention and ergonomics found in this study, one potential strategic plan for the university to establish such programs is to have health professions students involved in service-learning activities in this area on campuses.

Conflict of interest

None to report.

References

Pencak

. Workplace health promotion programs. An overview. The Nursing clinics of North America. 1991;26(1):233–40.

Hunt

. Assessment of health promotion and disease prevention at colleges and universities in the southeastern United States. ICHPER–SD Journal. 1999;35(4):55–7.

McMillen

. Colleges Finding ‘Wellness’ Programs Cut Absenteeism, Boost Productivity and Morale of Their Staff Members. Chron High Educ. 1986;31(23):20–2.

Mayfield

. Health,Wellness, and Employee Assistance:A Holistic Approach to Employee Benefits. NE Washington, DC: Bureau of Labor Statistics.; 2011. pp. 1-12.

Rongen

, Robroek

SJW

, van Lenthe

, Burdorf

. Workplace health promotion: a meta-analysis of effectiveness. American Journal of Preventive Medicine. 2013;44(4):406–15.

Baicker

, Cutler

, Song

. Workplace wellness programs can generate savings. Health Affairs (Project Hope). 2010;29(2):304–11.

Ryan

, Grant

, Dall

, Granat

. Sitting patterns at work: Objective measurement of adherence to current recommendations. Ergonomics. 2011;54(6):531–8.

Freedman

, Rubinstein

. Obesity and food choices among faculty and staff at a large urban university. Journal of American College Health: J of ACH. 2010;59(3):205–10.

Biron

, Brun

, Ivers

. Extent and sources of occupational stress in university staff. Work (Reading, Mass). 2008;30(4):511–22.

10.

Mark

, Smith

. Effects of occupational stress, job characteristics, coping, and attributional style on the mental health and job satisfaction of university employees. Anxiety Stress Coping. 2012;25(1):63–78.

11.

Fisher

, Konkel

, Harvey

. Musculoskeletal injuries associated with selected university staff and faculty in an office environment. Work (Reading, Mass). 2004;22(3):195–205.

12.

Cann

, Baker

, Hansen

, Massie

, Vandervoort

. A five year retrospective analysis of occupational injuries and incidence reported at a research intensive Canadian university. Work (Reading, Mass). 2008;30(2):171–84.

13.

Jaskolka

, Andrews

, Harold

. Occupational injuries reported in a Canadian university setting: a five year retrospective study. Work (Reading, Mass). 2009;34(3):273–83.

14.

Plotnikoff

, Collins

, Williams

, Germov

, Callister

. Effectiveness of interventions targeting health behaviors in university and college staff: a systematic review. American Journal of Health Promotion: AJHP. 2015;29(5):e169–87.

15.

Linnan

, Cluff

, Lang

, Penne

, Leff

. Results of the Workplace Health in America Survey. Am J Health Promot. 2019;33(5):652–65.

16.

Mattke

, Schnyer

, Van Busum

. A review of the U.S. workplace wellness market. Rand Health Quarterly. 2013;2(4):7.

17.

McCleary

, Goetzel

, Roemer

, Berko

, Kent

, De La Torre

. Employer and employee opinions about workplace health promotion (wellness) programs: Results of the Harris Poll Nielsen Survey. J Occup Environ Med. 2017;59(3):256–63.

18.

Zimmer

, Hill

, Sonnad

. A scope-of-practice survey leading to the development of standards of practice for health promotion in higher education. Journal of American College Health: J of ACH. 2003;51(6):247–54.

19.

Lloyd

, Crixell

, Bezner

, Forester

, Swearingen

. Genesis of an Employee Wellness Program at a Large University. Health Promotion Practice. 2017;18(6):879–94.

20.

Kupchella

. Colleges and universities should give more broad-based attention to health and wellness-at all levels. Journal of American College Health: J of ACH. 2009;58(2):185–6.

21.

Reger

, Williams

, Kolar

, Smith

, Douglas

. Implementing university-based wellness: A participatory planning approach. Health Promot Pract. 2002;3(4):507–14.

22.

Leininger

, Adams

, DeBeliso

. Differences in health promotion program participation, barriers and physical activity among faculty, staff and administration at a university worksite. Int J Workplace Health Manag. 2015;8(4):246–55.

23.

Thornton

, Johnson

. Community college employee wellness programs. CCJRP. 2010;34(12):966–76.

24.

Linnan

, Brooks

, Haws

, Benedict

, Birken

, French

, et al. Community colleges as settings for promoting employee health. Am J Health Stud. 2010;25(2):86–91.

25.

Linnan

, Arandia

, Naseer

, Li

, Pomerantz

, Diehl

. Assessing Opportunities to Enhance Comprehensive Health Promotion and Wellness Programming in a State Community College System. N C Med J. 2017;78(5):296–303.

26.

Bichsel

, McChesney

, Pritchard

. Healthcare Benefits for Higher Education Employees: Key Findings and Summary Tables for the 2018-19 Academic Year (Research Report) Knoxville, TN: CUPA-HR; July 2019 [Available from: https://www.cupahr.org/surveys/results/benefits-in-higher-education/.

27.

Brauer

, Dewald

, O’Brien

. Trend results from three surveys assessing faculty and staff wellness initiatives 2018 [Available from: https://www.acha.org/documents/Networks/Coalitions/Results_from_Surveys_Assessing_Faculty_and_Staff_Wellness_Initiatives.pdf.

28.

Hanson

. How many institutions care about faculty and staff health programs? Int J Health Promot Educ. 2013;51(2):75–84.

29.

Mickey

, Greenland

. The impact of confounder selection criteria on effect estimation. Am J Epidemiol. 1989;129(1):125–37.

30.

Linnan

, Cluff

, Lang

, Penne

, Leff

. Results of the Workplace Health in America Survey. American Journal of Health Promotion. 2019;33(5):652–65.

31.

US Department of Health and Human Services. Healthy People 2010. With Understanding and Improving Health and Objectives for Improving Health. 2nd ed. Washington, DC: US Department of Health and Human Services; 2000.

32.

Saleh

, Fuortes

, Vaughn

, Bauer

. Epidemiology of occupational injuries and illnesses in a university population: a focus on age and gender differences. Am J Ind Med. 2001;39(6):581–6.