The Influence of Worksite and Employee Variables on Employee Engagement in Telephonic Health Coaching Programs: A Retrospective Multivariate Analysis

Abstract

Purpose.

This study assessed 11 determinants of health coaching program participation.

Design.

A cross-sectional study design used secondary data to assess the role of six employee-level and five worksite-level variables on telephone-based coaching enrollment, active participation, and completion.

Setting.

Data was provided by a national provider of worksite health promotion program services for employers.

Subjects.

A random sample of 34,291 employees from 52 companies was selected for inclusion in the study.

Measures.

Survey-based measures included age, gender, job type, health risk status, tobacco risk, social support, financial incentives, comprehensive communications, senior leadership support, cultural support, and comprehensive program design.

Analysis.

Gender-stratified multivariate logistic regression models were applied using backwards elimination procedures to yield parsimonious prediction models for each of the dependent variables.

Results.

Employees were more likely to enroll in coaching programs if they were older, female, and in poorer health, and if they were at worksites with fewer environmental supports for health, clear financial incentives for participation in coaching, more comprehensive communications, and more comprehensive programs. Once employees were enrolled, program completion was greater among those who were older, did not use tobacco, worked at a company with strong communications, and had fewer environmental supports for health.

Conclusion.

Both worksite-level and employee-level factors have significant influences on health coaching engagement, and there are gender differences in the strength of these predictors.

Keywords

Worksite Participation Health Promotion Telephone-Based Intervention Recruitment Retention Prevention Research Manuscript format: research Research purpose: modeling/relationship testing Study design: nonexperimental Outcome measure: behavioral Setting: workplace Health focus: fitness/physical activity,nutrition,smoking control,stress management,weight control Strategy: incentives,built environment Target population age: adults Target population circumstances: education/income level

Get full access to this article

View all access options for this article.

References

Claxton

Gabel

DiJulio

. Health benefits in 2008: Premiums moderately higher, while enrollment in consumer-directed plans rises in small firms. Health Aff (Millwood). 2008;27:w492–w502. doi:10.1377/hlthaff.27.26.w492.

Hewitt Associates LLC. Two Roads Diverged: Hewitt's Annual Health Care Survey. Lincolnshire, Ill: Hewitt Associates, LLC; 2008.

Linnan

Bowling

Childress

. Results of the 2004 National Worksite Health Promotion Survey. Am J Public Health. 2008;98:1503–1509.

Pelletier

. A review and analysis of the clinical and cost-effectiveness studies of comprehensive health promotion and disease management programs at the worksite: Update VI 2000–2004. J Occup Environ Med. 2005;47:1051–1058.

Baicker

Cutler

Song

. Workplace wellness programs can generate savings. Health Aff (Millwood). 2010;29:304–311.

Serxner

Noeldner

Gold

. Best practices for an integrated population health management (PHM) program. Am J Health Promot. 2006;20(suppl):1–10, iii.

Goetzel

Ozminkowski

. The health and cost benefits of work site health-promotion programs. Annu Rev Public Health. 2008;29:303–323.

Goetzel

Ozminkowski

Asciutto

. Medstat Group I. Survey of Koop award winners: Life-cycle insights. Am J Health Promot. 2001;15(5):TAHP-1.

Goetzel

Shechter

Ozminkowski

. Promising practices in employer health and productivity management efforts: Findings from a benchmarking study. J Occup Environ Med. 2007;49:111–130.

10.

Terry

Seaverson

Grossmeier

Anderson

. Association between nine quality components and superior worksite health management program results. J Occup Environ Med. 2008;50:633–641.

11.

Robroek

van Lenthe

van Empelen

Burdorf

. Determinants of participation in worksite health promotion programmes: A systematic review. Int J Behav Nutr Phys Act. 2009;6:26.

12.

Glasgow

McCaul

Fisher

. Participation in worksite health promotion: A critique of the literature and recommendations for future practice. Health Educ Q. 1993;20:391–408.

13.

Lovato

Green

. Maintaining employee participation in workplace health promotion programs. Health Educ Q. 1990;17:73–88.

14.

Anderson

Grossmeier

Seaverson

Snyder

. The role of financial incentives in driving employee engagement in health management. ACSM Health Fitness J. 2008;12:18–22.

15.

Martinez

VanWormer

Pronk

. The role of incentives and communication on health assessment participation. ACSM Health Fitness J. 2008;12:41.

16.

Seaverson

ELD

Grossmeier

Miller

Anderson

. The role of incentive design, incentive value, communications strategy and worksite culture on health risk assessment participation. Am J Health Promot. 2009;23:343–352.

17.

Taitel

Haufle

Heck

. Incentives and other factors associated with employee participation in health risk assessments. J Occup Environ Med. 2008;50:863–872.

18.

Wilhide

Hayes

Farah

. The use and influence of employee incentives on participation and throughput in a telephonic disease management program. Popul Health Manag. 2008;11:197–202.

19.

Institute of Medicine of the National Academies. The Future of the Public's Health in the 21st Century. Washington, DC: National Academies Press; 2003.

20.

Sallis

Owen

. Ecological models. In: Glanz

Lewis

Rimer

, eds. Health Behavior and Health Education: Theory, Research, and Practice. 2nd ed. San Francisco, Calif: Jossey-Bass Inc; 1997:403–424.

21.

SAS Institute Inc. SAS/Stat 9.2 User's Guide: Introduction to Power and Sample Size Analysis. March 2008 ed. Cary, NC: SAS Institute Inc; 2008.

22.

StayWell Health Management. HealthPath Health Risk Assessment. Version 5.1. St. Paul, Minn: The StayWell Company; 1987.

23.

Health Enhancement Research Organization. Employee Health Management Best Practice Scorecard. Version 3. Edina, Minn: Health Enhancement Research Organization; 2009.

24.

Terry

Seaverson

ELD

Staufacker

Gingerich

. A comparison of the effectiveness of a telephone coaching program and a mail-based program. Health Educ Behav. 2010;37:895–912.

25.

de Vaus

. Surveys in Social Research. 5th ed. New York, NY: Routledge; 2002.

26.

Alexander

Divine

Couper

. Effect of incentives and mailing features on online health program enrollment. Am J Prev Med. 2008;34:382–388.

27.

Brill

Kohl

Rogers

. The relationship between sociodemographic characteristics and recruitment, retention, and health improvements in a worksite health promotion program. Am J Health Promot. 1991;5:215–221.

28.

Gatewood

Litchfield

Ryan

. Perceived barriers to community-based health promotion program participation. Am J Health Behav. 2008;32:260–271.

29.

Grosch

Alterman

Petersen

Murphy

. Worksite health promotion programs in the U.S.: Factors associated with availability and participation. Am J Health Promot. 1998;13:36–45.

30.

Lando

Jeffery

McGovern

. Effects of intensity of staff training on program participation in religious organizations and worksites. Am J Health Promot. 1993;8:3.

31.

Terry

Fowles

Harvey

. Employee engagement in factors that affect enrollment compared with retention in two coaching programs—the ACTIVATE study. Popul Health Manag. 2010;13:115–122.

32.

Crump

Earp

JAL

Kozma

Hertz-Picciotto

. Effect of organization-level variables on differential employee participation in 10 federal worksite health promotion programs. Health Educ Behav. 1996;23:204–223.

33.

Rost

Connell

Schechtman

. Predictors of employee involvement in a worksite health promotion program. Health Educ Q. 1990;17:395–407.

34.

Sloan

Gruman

. Participation in workplace health promotion programs: The contribution of health and organizational factors. Health Educ Q. 1988;15:269–288.

35.

Patient Protection and Affordable Care Act. Title 1, Part 1, §2705 (2010).

36.

Lewis

Huebner

Yarborough

3rd . Characteristics of participants and nonparticipants in worksite health promotion. Am J Health Promot. 1996;11:99–106.