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Carrots, Not Sticks: Adverse Impact and Wellness Programs

Switzer, Fred S. III PhD; Cheung, Janelle H. PhD; Burns, Deanna K. PhD; Sinclair, Robert R. PhD; Roth, Philip L. PhD; Tyler, Peggy PhD; McCubbin, James PhD

Journal of Occupational and Environmental Medicine: March 2017 - Volume 59 - Issue 3 - p 250–255
doi: 10.1097/JOM.0000000000000940
Original Articles

Objective: The purpose of this study was to determine if wellness programs are likely to produce an adverse impact in various protected groups and to determine what features of the program may contribute to adverse impact.

Methods: Using a nationally representative sample of US adults, we examined the proportions of protected groups that would be expected to encounter adverse impact using various health factors such as weight, blood pressure, and cholesterol levels.

Results: The results of this study indicate that disincentive-based programs pose a high risk of differentially selecting protected groups into program categories. This is especially true for members of multiple protected classes.

Conclusions: We suggest organizations carefully consider both the type of program and the health factors incorporated into their wellness efforts and use incentives rather than disincentives to encourage health promotion.

Department of Psychology (Drs Switzer, Cheung, Burns, Sinclair, Tyler, McCubbin); and Department of Management, Clemson University, Clemson, South Carolina (Dr Roth).

Address correspondence to: Fred S. Switzer III, PhD, Department of Psychology, Clemson University, 410F Brackett Hall, Clemson, SC 29634 (

This study was funded internally by Clemson University.

Authors Switzer, Cheung, Burns, Sinclair, Roth, Tyler, and McCubbin have no relationships/conditions/circumstances that present potential conflict of interest.

The JOEM editorial board and planners have no financial interest related to this research.

Copyright © 2017 by the American College of Occupational and Environmental Medicine