ANN ARBOR—Do work-site wellness programs work? Is there any single aspect of these company-sponsored programs that significantly improves employees’ health?

The answer is yes, according to the University of Michigan Health Management Research Center (HMRC). But it’s not one component—such as on-site cholesterol screening or exercise classes that makes the difference.

Participation in multiple programs may be the key to success.

The HMRC study, reported in the American Journal of Health Promotion, looked at 12,984 General Motors employees participating in the UAW-GM LifeSteps Health Promotion program. Each had completed a health risk appraisal (HRA) twice over a two- year period.

“The low-risk status group—persons having two or fewer health risks—increased from 64 percent of the total participants in year one to 67 percent in year two. This represents a significant net gain of 407 low-risk participants,” said study co-authors Louis Yen and Marilyn Edington.

Thirteen health measures were used to define the health status of the HRA participants at year one and year two. The high risk factors included being physically inactive; not using a safety belt; smoking; drinking 14 or more alcoholic beverages per week; biometric measures such as high blood pressure and overweight; and psychological measures such as low life satisfaction and a self-assessment of poor health.

“The LifeSteps program has two main health management strategies: reducing the health risks of high-risk employees and helping low-risk employees maintain that status,” according to Yen and Edington. “In the case of high-risk individuals, one-on-one focused interaction is an important element in the programming design.

“Comprehensive health promotion programs with multiple components have had the most positive results in reducing risks, especially when compared to work-sites with fewer wellness program options,” they stated.

In the case of LifeSteps, comprehensive programming includes the HRA, a 1-800 nurse advising phone service, a health self-care book, health information retrieval by audiotape, quarterly newsletters and a LifeSteps web page. More than 1 million GM employees, retirees and dependents aged 19 and older are eligible for these services.

In addition, study participants in two cities had access to an intense pilot program which offered on-site risk assessments, one-on-one health coaching for high risk participants, classes on various health topics, and health information resources. Some particularly high-risk participants also received vouchers for medical visits.

“A significant percentage of individuals with three or more risk factors at year one (high risk) changed to two or fewer risk factors in year two (low risk),” according to Yen and Edington. “The largest reduction of risk factors occurred among people who took part in the HRA and three or more other programs.”

Some individuals changed from low risk to high risk over the two-year period, and still others changed in both directions. “For example, if a person quit smoking but increased weight and stress to levels of high risk, that person would have one positive risk change and two negative risk changes,” the researchers explained.

For an organization such as UAW-GM, the “bottom line” is the net increase of 407 employees in the low-risk status group. “The finding is even more important given that UAW-GM has an older work force, among whom maintaining health risk status may be considered as favorable as improving it,” Edington noted.

GM’s Timothy McDonald and UAW’s David Hirschland also contributed to the research. They noted that while many work-site wellness studies look at a program’s cost-effectiveness and return on investment, this study focused exclusively on the health benefits to the participants.

“The findings in this study corroborate other studies showing that work-site wellness program participants have lower risks,” the HMRC researchers concluded. “And as participation increases in a comprehensive, multi-component program, healthy employees become even healthier.”

Health Management Research CenterAmerican Journal of Health PromotionLouis Yen