Implementation and evaluation of Employee Health and Wellness Program using RE-AIM framework

Purpose: The study describes the design, implementation and evaluation of an employer-sponsored health screening program – Employee Health and Wellness Program (EHWP) – in an academic healthcare system in Pakistan. Design/methodology/approach: One year after implementation, RE-AIM (reach, effectiveness, adoption, implementation and maintenance) framework was used to evaluate and report participant- and organizational-level indicators of success. Findings: Of the 5,286 invited employees, 4,523 (86%) completed blood work and 1809 (34%) completed health risk assessment (reach). Of the 915 (51%) who required referrals, 3% were referred for new diagnoses of diabetes, hepatitis C or severe anemia; 63% for elevated 10-year risk of cardiometabolic diseases (cardiovascular disease and diabetes); and 25% for counseling for depression, obesity or smoking cessation (effectiveness). Employees' barriers to enrollment were explored (adoption). While institutional costs were considered nominal (USD 20/employee), organizational barriers were identified (implementation). Finally, 97% of users reported interest in enrollment if EHWP was offered again (maintenance). Originality/value: In a country with minimal focus on adult preventive care, the study reports the impact of an employer-offered wellness program that identified new risk factors and offered a referral for ongoing care. Employees reported a positive experience and were willing to re-enroll. Using the RE-AIM framework, the study has defined indicators in the real-world setting that can be used effectively by other institutions to start such a program.