All ETDs from UAB

Advisory Committee Chair

Michael Crowe

Advisory Committee Members

Olivio Clay

Lesley Ross

David Redden

Connie Kohler

Joseph Schumacher

Document Type


Date of Award


Degree Name by School

Doctor of Philosophy (PhD) College of Arts and Sciences


This study examined participation, engagement, and achievement of health-related targets under two sequentially administered wellness programs for approximately 2,000 full-time city personnel of a Southern municipal government. Program A utilized paper fliers and community posters as the primary communication strategy and incented employees for achieving 3 health outcomes only by a lump-sum, one-time monetary reward distributed at the end of the year. Program B subsequently utilized a web-based site where employees logged into individualized accounts and received points that accrued for both completing behaviors and achieving health outcomes. Both electronic and paper communication strategies were utilized to as primary mediums to inform employees and points were awarded as behaviors or outcomes were achieved. Results of McNemar chi-square analyses indicated a significant increase in employee engagement and achievement of a healthy blood pressure during Program B when compared to Program A, where this finding was consistent for both healthy and chronic diseased personnel. Logistic Regression models indicated those employees with a chronic disease showed an increased likelihood of completion of a health risk assessment under both programs, but people with specific diseases like Hypertension and Asthma/Respiratory-related illnesses showed a higher likelihood of completing the assessment under Program B. In terms of demographic predictors of program participation, older age and lower income were associated with reduced participation in both programs. When race was examined without salary as a covariate, there was an increased likelihood of Caucasian employees to participate during Program A when compared to minority employees. This result was not found for Program B, where both minority and non-minority personnel had a comparable likelihood of participation. Findings of this study supply additional support that communication methods and mediums in addition to incentive value may play a role in motivating employees to utilize wellness resources provided by their employer. The type of incentive as well as the schedule through which they are rewarded to employees also may have impacts on initial involvement and continued engagement in such programs. Future research should attempt to analyze these components separately and determine their individual effects on employee decision-making as it relates to health behavior choices in the workplace.



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