Critical Success Factors for setting up Result-oriented Wellness Programmes

When a company can produce more than its competitors—even though they have the same amount of resources—it has an absolute advantage. We believe wellness is that advantage.’ WELCOA

According to benchmark studies, there are a number of common elements inherent in successful employee wellness programmes. The Wellness Councils of America (WELCOA), has distilled these elements into the “Seven C’s.” which have been used as the benchmarks behind quality results oriented employee wellness programs for over a decade. WELCOA’s “Seven C’s” approach offers the direction needed to transforms wellness programs into strategic initiatives that attain measurable results. This understanding is corroborated by Price Waterhouse Coopers, Health, Work Wellbeing, through their work on reviewing the wider business case in the UK and the resultant framework on best practice in programme implementation.

The essence of these works and many others is that although wellness programme vary depending on the organisations, size and people2structure, key health and wellness challenges and risks and available resources, there appears to be a number of common principles for successful planning and implementation of wellness programmes and these include the following:

Leadership/Senior Management Support and Buy-in:

Just like with any business, the most critical factor or an enabler for programme success is support and participation from senior management. We have seen this with the HIV & AIDS response in the region. It was the former President Mr Mogae’s leadership that Botswana performed way better than many countries in the fight against HIV & AIDS.

Support can be shown through a number of ways, one of which is communication. It is a known fact that communication is a requirement for any leader who wants to get things done. This equally applies to wellness. Clear and regular communication on wellness must be given by the leader to make people understand and appreciate wellness as important and a priority to the organisation. It is proven that CEOs who take every available opportunity to communicate the wellness message have more effective results.

Leadership support also comes in the form of resource allocation, including freeing time for wellness activities. However it is important to note that leadership must go beyond endorsing wellness programmes though funding but involve active and visible participation in wellness initiatives. This is of critical importance because people tend to respond to those they perceive as role models or those who have a personal connection and influence. Senior managers may not always have the skill nor know-how regarding meaningful participation. To remove such barriers, they can be coached on their role as wellness leaders as well as on their own wellness prior to rolling out the wider programme.


Creating a Cohesive Wellness team

The second critical enabler benchmark associated with success of wellness programmes is the creation and integration of a well-functioning team. This wellness team/committee, typically made up of representatives from various departments including the union, is responsible for the promotion of the programme, its planning and evaluation. Taking a team approach obviously lightens the load but it also creates an opportunity for engaging with and getting input from the organisation’s key players, thereby increasing the chance of successfully assimilating the wellness culture into the fabric of the organisation.

Assessing the workplace to drive the wellness plan

Assessing the organisational specific needs and individual interest is pertinent to the success of a wellness programme. Literature and case study review in fact shows that collecting and analysing data may very well be the most important aspect of planning an effective value-adding wellness programme. This step offers an understanding of the employee population, highlighting the areas of risk needing intervention. It therefore is critical in informing the programmes scope as well as content and approach to wellness initiatives. Further to that, the assessment results provide a baseline necessary for future programme evaluation to measure progress.

Some sources of data for an assessment and analysis of the current wellness status of an organisation typically include employee health data obtained through health risk assessments (HRAs) and health screening (BP, blood sugar, cholesterol etc.); employee productivity data such as absenteeism and organisational data such as modifiable health care claims where possible as well as current wellness-related policies and the organisations health and wellness culture and practices. Put together all this information creates a solid foundation from which a result-oriented programme can be built.

Crafting a wellness framework and operating plan and choosing appropriate wellness interventions.

Crafting an effective operating plan is the next important factor. A framework and plan provides alignment such that all players move in tandem towards a common goal, helps with avoiding fragmentation and facilitates effective programme evaluation. It has indeed been found that organisations that get into programming without a proper operating plan often fail to show the impact of the programme and its return on value.

Interventions offered and articulated in the framework are founded upon what was unearthed through the assessments. This makes the programme appropriate for the organisation’s needs and the interest of its workforce therefore positioning it in better light for effectiveness and success. Issues to consider in programming besides the choice of interventions include the intensity of the interventions – will they be awareness, education, behaviour change or cultural enhancement focused; how often the programme will be offered and whether there will be any incentives used to increase participation. It should be noted that although organisations are different especially in terms of their organisational risk in relation to their wellness agenda, there are a number of initiatives that will be appropriatefor any working population and these include things like psycho-social support (counselling/Employee Assistance Programmes (EAP)), physical activity, nutrition/weight management and stress and financial management amongst others.

Creating a supportive wellness promoting environment

The other important benchmark is to create an environment supportive of a wellness culture.A supportive environment plays a critical role in helping employees adopt healthier behaviours and lifestyles. Experience has also taught us that awareness and education alone are not enough to bring about desired change in behaviour – case in point the national HIV & AIDS programme. Wellness programming should therefore involve creation of a supportive social and physical environment where healthy decisions are the norm. This can be done by clearly defining the organisation’s expectations regarding healthy behaviours through policies and environmental changes (cultural and physical) that foster integration of wellness in the organisations way of doing business, policies that promote wellness and prevent or reduce risk of disease or productivity. In such environments, maintaining and sustaining behaviour change becomes a whole lot easier.

Practically what this means is that sustained behaviour change cannot be expected from an organisation that offers weight management classes and yet offering high fat high sugar non-nutritious food in its vending machines and/or cafeterias. In such an instance, a food or nutrition policy would be in order. Other examples of remarkable environmental modifications include putting up fitness facilities and policies that ensure release time for wellness activities to promote participation.

Carefully evaluating outcomes

The final critical success factor of results oriented wellness programmes is to do with carefully evaluating programme outcomes. Establishing monitoring and evaluation of programmes processes, outcomes and financial impact is vital for any wellness initiative. A sound evaluation strategy provides understanding regarding which elements of the programme work and which need attention. According to WELCOA, there are eight (8) primary variables which make excellent evaluation targets. These include participation, participant satisfaction, improvement in knowledge, attitude and behaviour (HRAs), change in biometric measures, risk factors, physical environment and organisational culture, productivity and return on investment.

Although a basic measure, participation is believed to be an excellent barometer of how the programme is doing. Clearly for a programme to have impact is has to have people taking up the interventions in the first place. Regarding the idea of monitoring risk factor change, this has gained considerable popularity, the idea being to identify high risk individuals, defined as having 4 or more risk factors), intervene and make sure they don’t progress to a worse state. Productivity as an evaluation target measures the impact of the programme on productivity measures such as absenteeism, employee morale, staff turn over etc.

Best Practice indicates evaluation as something that must be performed on an annual basis. On-going evaluation must continue to inform the programme development and design to ensure the programme has maximal impact and reach and that it continues to meet changing needs.


Dr Onalethata Johnson, Director ICAS Botswana

Sunday Standard, 2013