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Issue 34

Very small businesses: Increasing wellness program resources

By David S. Weed, Psy.D., Executive Director, and Angela Bras, Worksite Wellness Coordinator, Partners for a Healthier Community, Inc., Fall River, MA.

Issue #34

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While nearly half of employees in larger corporations have access to some type of wellness program at work, employees of very small organizations (e.g. under 20) rarely get assistance from their employer in improving or maintaining good health. Sixty-nine percent of all businesses in America have fewer than twenty employees. Although this represents only eighteen percent of the total workforce, it is a significant number of people (almost 22 million in 2007) who have no access to employer-provided wellness resources. In order to address this problem, a pilot project was funded through CPH-NEW that used community-based resources to reach this group.

The Small Worksite Wellness Project (SWWP) recruited seventeen small employers in a pilot project designed to engage their employees in health promotional behavior over a six month period. Organizations and businesses with between five and twenty-five employees were invited to survey their employee needs and interests and then to incentivize them to participate in a variety of community-based activities outside of their regular work time. The program was offered at no cost to the employer and provided on-site consultation, resource guides and invitations to employers to participate in Wellness Collaborative meetings with other employers.

It was understood that employers in these small businesses would not be able to give employees work-time off to engage in wellness activities and that they would have to engage in them on their own time and at their own expense. However, employers might serve as good sources of information about what community resources were available and how to access them and potentially become significant motivators for some employees to become engaged.

Community-based activities included fitness programs, nutrition education opportunities, smoking cessation, substance abuse prevention, stress management, and other specific interventions designed to reduce illness or injury both on and off the job. Information on other resources such as farmers’ markets and walking and bicycle routes were also included in information provided to employers. Many activities were either no or very low cost for employees through programs at local organizations who have been engaged in an ongoing health promotion for several years. A popular program was a city-wide Fitness Challenge that ran during the study period and offered twice-weekly workouts and nutrition education for only five dollars over a five-month period.

The project measured and evaluated ten program elements, including employer response to the invitation and reasons for and against participation, employee engagement and participation, and the helpfulness and effectiveness of using community-based resources to engage employees in smaller worksites in worksite health promotion.

The study demonstrated that a program to encourage employers of small businesses to participate in a wellness program that leverages existing community resources was beneficial to a number of employers. Receipt of assessment tools and information about local resources were seen by employers as the most helpful element of the project. Employees of these small businesses appeared to be aware of their employer’s attempts to provide wellness resources and found it helpful to know about them, whether or not they participated in them. Employees also reported less stress, sick time and fewer injuries over the study period, although there were small numbers of people reporting each of these, and it was not possible to determine if the lower numbers resulted from participation in wellness activities.

One employer, a small law office, wrote after the conclusion of the study: “We now have a resource center encompassing the manual you provided as well as a bulletin board to post ideas and information on local wellness events and activities. A few members are participating in our own little ‘walking club’ .... and we will soon be evaluating our workspace for improved functionality and design.”

Employers who participated in the project found assessment tools, resource notebooks, listing of local resources, fitness challenge participation and on-site consultation to be the most helpful elements, especially in terms of improving employee morale. Web-based resource listings, worksite wellness collaboration, on-site education, on-site resources, and promotional items were least likely to be seen as helpful.

Employees of small businesses were mostly satisfied with the resources that were provided by their employers, especially women employees over the age of 56. Employees appeared to be aware of employer participation in the project, with more than half of the employees involved in some aspect of the wellness program. Resources related to nutrition, exercise and stress reduction drew the greatest interest among employees. A small number of employees reported engaging in activities in these areas outside of work hours. It is hoped that this model can be continued and expanded to include other employers, as it presents a way to engage the significant numbers of employees who remain outside traditional employer-based wellness programs.

David Weed is Executive Director of Partners for a Healthier Community (PHC), Inc., where he coordinates the Healthy City Fall River initiative between the Mayor's Office and the Mass. Department of Public Health. Begun in 2003, this has involved over 1,000 projects to improve the health and quality of life of those who live and work in the city ( Angela Bras is Worksite Wellness Coordinator for PHC, providing assessment, consultation and coordination of community resources to large and small employers in the Greater Fall River area.


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CPH-NEW, a Center for Excellence to Promote a Healthier Workforce of the National Institute for Occupational Safety and Health, is a joint initiative of the University of Massachusetts Lowell and the University of Connecticut. CPH-News & Views is a semi-monthly column written by Center researchers on emerging topics related to healthy workplaces. These comments reflect thoughts of the individual researchers and do not represent conclusive research summaries, nor do they necessarily reflect a consensus among all Center personnel. We welcome your responses and discussion. Please send all questions and comments to

CPH News and Views Issue 34

© Copyright 2013 The Center for the Promotion of Health in the New England Workplace (CPH-NEW)

December 2013