title: Systematic review of the impact of worksite wellness programs.
abstract: To analyze the impact of worksite wellness programs on health and financial outcomes, and the effect of incentives on participation.
  
  
  
  Sources were PubMed, CINAHL and EconLit, Embase, Web of Science, and Cochrane for 2000-2011. We examined articles with comparison groups that assessed health-related behaviors, physiologic markers, healthcare cost, and absenteeism. Data on intervention, outcome, size, industry, research design, and incentive use were extracted.
  
  
  
  A total of 33 studies evaluated 63 outcomes. Positive effects were found for threefourths of observational designs compared with half of outcomes in randomized controlled trials. A total of 8 of 13 studies found improvements in physical activity, 6 of 12 in diet, 6 of 12 in body mass index/weight, and 3 of 4 in mental health. A total of 6 of 7 studies on tobacco and 2 of 3 on alcohol use found significant reductions. All 4 studies on absenteeism and 7 of 8 on healthcare costs estimated significant decreases. Only 2 of 23 studies evaluated the impact of incentives and found positive health outcomes and decreased costs.
  
  
  
  The studies yielded mixed results regarding impact of wellness programs on healthrelated behaviors, substance use, physiologic markers, and cost, while the evidence for effects on absenteeism and mental health is insufficient. The validity of those findings is reduced by the lack of rigorous evaluation designs. Further, the body of publications is in stark contrast to the widespread use of such programs, and research on the effect of incentives is lacking.
authors.affiliation: RAND, Santa Monica, CA, USA. Mattke@rand.org
authors.forename: Karen Chan
authors.initials: KC
authors.lastname: Osilla
authors.forename: Kristin
authors.initials: K
authors.lastname: Van Busum
authors.forename: Christopher
authors.initials: C
authors.lastname: Schnyer
authors.forename: Jody Wozar
authors.initials: JW
authors.lastname: Larkin
authors.forename: Christine
authors.initials: C
authors.lastname: Eibner
authors.forename: Soeren
authors.initials: S
authors.lastname: Mattke
mesh_terms: D003256:Community Participation; D003362:Cost-Benefit Analysis; D016206:Databases, Bibliographic; D005069:Evaluation Studies as Topic; D006293:Health Promotion; D006801:Humans; D009042:Motivation; D009786:Occupational Health Services; D017132:Workplace