| Employers invest in health coaching programs to improve employee health and mitigate health care cost increases but evidence suggests employee participation in these programs is not reaching the level necessary to yield desired health and financial outcomes. Based on an ecologic model, the purpose of this retrospective quantitative study was to assess the influence of employee-level and worksite-level determinants of coaching program engagement. Drawing on secondary data sources, a random sample of 34,291 employees from 52 U.S. companies was used to detect significant relationships between 11 independent variables and 4 dependent variables using multivariate logistic regression models. Study results were consistent with the tenets of an ecological model, finding worksite and employee variables were significant predictors of engagement in coaching programs. Employees were more likely to enroll in any coaching programs if they were older, female, and in poorer health. Overall, with the exception of variability in senior leadership support, all of these predictors were associated with enrollment in phone-based coaching programs: Employees had fewer environmental supports for health, clear financial incentives for participation in coaching, comprehensive communications, and comprehensive programs. Once enrolled employee program completion was influenced by the employees being older, not using tobacco, working at a company with strong communications, and having fewer environmental supports for health. The social change contributions of this study include using empirically derived variables to plan employee health policy, target the allocation of resources, and promote health coaching programs in which employees enroll, engage, and complete. |
