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A Leading by Example report reviews the challenges small and medium-sized employers have in implementing a worksite health promotion program.

Perceived expense. Many companies are challenged to maintain adequate cash flow, let alone invest in health promotion programs. The fact is that program costs can be very modest or free by leveraging internal and external resources.

High turnover. Small/medium-sized companies typically have high employee turnover. Employers question the investment when an employee may be gone within a year. On the other hand, health promotion can be viewed as a recruiting and retention tool that reinforces a healthy and supportive work environment.

Limited staff. There are many creative ways to leverage staff that don’t interfere with business operations, such as recruiting and supporting employee wellness champions to help organize health promotion activities.

Privacy issues. Because of the size of small/medium-sized employers, health promotion programs can be viewed as intrusive. When implemented properly, the intent and benefits of these programs can be communicated
effectively while privacy is protected.

Existing programs. Many health plans provide wellness content/resources on their Web sites as well as preventive services within their benefit design. However, findings from Partnership for Prevention show that onsite
programming or other subsidies may be limited to companies of 50 employees or more and thus exclude smaller employers.

The whole report is worth reading.