Development, implementation and evaluation of a workplace wellness program: The Blue Care Staff Wellness case study

Workplace wellness programs are becoming increasingly popular as the potential value of health and productivity in the workplace and extended populations is appreciated. Historically, workplace wellness programs have focused on individual health risk variables as opposed to holistic wellness outcomes or measures. Furthermore, workplace wellness programming inclusive of wellness outcomes and measures has not yet received comprehensive evaluation or vigorous research. Yet there is increasing evidence to suggest that a holistic, evidence based approach to workplace wellness promotion is needed. The purpose of this research was to investigate the lifecycle of workplace wellness through the development, implementation and evaluation of a comprehensive workplace wellness pilot program framework for a multi-site, geographically dispersed health care provider. The Blue Care Staff Wellness program was a quasi-experimental twelve-month workplace wellness program, piloted in 44 Blue Care services in the Central Queensland and Fraser Coast regions of Queensland Australia. Study 1 describes the development of the Blue Care Staff Wellness Program framework in direct response to a recognised need for consistent and wellness focused constructs for workplace wellness promotion and dissemination. The framework promotes and supports the individual and organisational wellness of the Blue Care employee population by adopting consistent wellness principles to guide the framework conception and theory based development. The conceptual and process framework forms the basis for evaluation within the subsequent studies. Study 2 utilised the RE-AIM (Reach, Efficacy, Adoption, Implementation, and Maintenance) framework to provide a quantitative evaluation of the wellness and health culture impact of the Blue Care Staff Wellness Program framework pilot. The evaluation demonstrated poor reach (N=130, 12%), particularly amongst frontline staff without direct computer access. Significant changes were observed in both Individual Wellness (p=0.000) and Wellness Satisfaction (p=0.000) scores and Workplace Health Culture Audit scores (p=0.004). Furthermore, a 93.1% adoption rate (based on participant registration at eligible services) was observed amongst services, reflecting high organisational engagement. A global implementation score iv (based on socio-ecological intervention components intrapersonal, interpersonal, organisational, community and policy) of 61/100 was observed. A total of 63 (48.5%) participants dropped out of the program. Of these, 57 were no longer employed with Blue Care, reflecting a 44% staff turnover rate. The Blue Care Staff Wellness Program significantly improved individual staff wellness and organisational health culture for the sample population, suggesting the potential for inclusion of wellness and health culture as plausible workplace wellness promotion outcome measures. Study 3 provided a qualitative evaluation of the Blue Care Staff Wellness Program. A thematic qualitative analysis of a series of semi-structured interviews with volunteer Wellness Ambassadors and a focus group with Service Managers was undertaken. The thematic analysis revealed four themes for workplace wellness implementation barriers in a multi-site geographically diverse health care provider: individual [demographics, knowledge and skills], organisational [provision and access to resources, workplace structure and policy], environmental [geography, support] and operational [questionnaires, participation]. Qualitative evaluation of workplace wellness promotion provides valuable insights concerning best practices and principles of workplace wellness promotion, specifically within the Australian health care sector. This study highlighted contextually relevant barriers to workplace wellness promotion, particularly valuable in the dissemination and improvement of workplace wellness research and promotion. In conclusion, the development of a pilot framework for the delivery of a workplace wellness program within a multi-site geographically dispersed health care sector provider filled a current research and practice gap. Furthermore, quantitative analysis revealed a significant improvement in wellness and health culture for program participants despite poor program reach. Qualitative analysis identified a series of program implementation and participation barriers pertaining to individual, organisational, environmental and operational themes. Future research within workplace wellness programming should focus on further demonstrating the wellness and health culture outcomes of comprehensive programming so as to better develop the theoretical basis for program interventions.