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WellSteps Research

The WellSteps model is based on evidence that demonstrated a positive ROI, changes in health risk and behavior in both small and mid-sized companies.

Dr. Steven Aldana and Dr. Troy Adams are frequently asked how their research was used to create WellSteps. Here is the answer.

1. How Is The WellSteps Model Evidence-Based?

The goal of all Wellness programs should be to cost-effectively improve employee health behavior. How? Dr Adams reviewed, then summarized 17 years of evidence to help answer this question. There are basically two approaches: group-based programs like the Coronary Health Improvement Project and the Ornish program, or a one-on-one oriented program such lifestyle health coaching.

We have evaluated both approaches and have concluded that the group-based approach is more effective and cost-effective.

 The group-based approach significantly improves health and well-being in both community and worksite settings. These studies show that cardiovascular risk factors, depression and stress were reduced, and physical activity, nutrition, and sleep were all improved. The group approach yielded similar results whether the group was facilitated live or via video. We have also reviewed and evaluated the impact of health culture on program outcomes.


2. Can Wellness Programs Bend the Cost Trend?

Dr. Aldana wrote a widely cited review of the impact of wellness programs on financial outcomes. This research and that of many colleagues was used to create the WellSteps ROI Calculator.


3. Can Wellness Programs Impact Absenteeism, Presenteeism and Pharmacy Utliization?

Dr. Aldana co-authored an important review of wellness program impact on employee absenteeism. We know that lower absenteeism is strongly associated with fewer risk factors, greater physical activity, and lower levels of stress.


4. Do Wellness Programs Reduce Chronic Disease?

The CDC estimates that 75% of health care costs are due to chronic disease. This is the case for virtually every other health-related employee cost as well. So Wellness programs must have an impact on chronic disease.  From the evidence below, we know that well-designed programs can reduce, reverse and even arrest chronic disease.


5. Do Wellness Programs Improve Quality of Life and Health Outcomes?

We have evaluated several programs in a variety of settings to assess the impact of Wellness programs on quality of life and other health outcomes. The research indicates that wellness programs can be effective whether they are delivered onsite, by a mobile van, in small companies or led by trained peers.


6. Can Wellness Programs Change Behavior?

If chronic disease is the primary driver of cost, what is driving chronic disease?  According to the Nurses Health Study, 70-90% of chronic disease is related to lifestyle. So an effective wellness program should demonstrate the ability to improve health behavior. Our research indicates that wellness programs can increase physical activity; improve nutrition behaviors such as fruit, vegetable and whole grain intake.


7. How Can We Effectively Promote Behavior Change?

How to promote behavior change is a much asked research question. To address this question, Dr. Adams designed and coordinated a comprehensive review of leading behavior change theory – The Transtheoretical Model (TTM). The review process consumed 10 years and resulted in several papers. Additionally, theory-based research tools have been developed and evaluated, and the impact of theory-based interventions have been assessed.


8. What Associations Might Shed Light on the Behavior Change Process?

Understanding the determinants of behavior change is an important piece to the behavior change puzzle. Much research in a variety of populations has been conducted to help us better understand how to promote behavior change.


9. What Psychological Factors Might Influence Behavior Change?

As we have tried to understand ways to better promote wellness, we have studied attitudes, perceptions and personality characteristics. This understanding has helped as we have built our solutions and designed every campaign.


10. What About Health Coaching?

We provided an overview of the health coaching research. As of 2016, there were only 19 studies supporting the impact of health coaching on a variety of health behaviors. Health coaching is a promising tool that is best used with other wellness tools in a comprehensive program. The evidence supporting the effectiveness of health coaching is growing, but health coaching alone is a very costly and resource intensive intervention.