EMPLOYEES’ ATTITUDES, AWARENESS OF, PARTICIPATION AND SATISFACTION WITH THE WELLNESS MANAGEMENT PROGRAMME OF A NATIONAL GOVERNMENT DEPARTMENT R.B. MKANSI orcid.org : 0000-0002-1840-4666 Mini-Dissertation submitted in fulfilment of the requirements for the degree Magister in Business Administration at the North-West University Supervisor: Prof P.A. Botha Graduation ceremony April 2019 Student number: 16410785 i DECLARATION I, Rivalani Benneth Mkansi, hereby declare that the study entitled “Employees’ attitudes, awareness of, participation and satisfaction with the wellness management programme of a national government department” has not been conducted before nor submitted before at this university or any other university by myself or anybody. This study is original work and all authors that are used in the study have been duly acknowledged in the in-text citations and also the complete reference list. ………………………………. Rivalani Benneth Mkansi Student Number: 16410785 ii DEDICATION AND ACKNOWLEDGEMENT First and foremost, I would like to thank the Heavenly Father, Lord God my saviour for giving me strength and the wisdom to successfully complete the MBA programme. Secondly, I would like to pass my sincere gratitude to my lovely wife, Masana Mkansi, my kids Delron, Tiyani, Tsakani, Rifumo and Risima for your support, understanding and helping me through my studies. I know it has not been an easy two years but you endured with me. Because of your support it was easy to balance work and study and family life was easy. I dedicate to you guys. To my colleagues, supervisor and subordinates at the Department of Labour, your support has been phenomenal; it made it easy to strike a balance between work and study. To the MBA Rustenburg group, you were so incredible. I remember vividly our sleepless nights working through group and individual assignments. Our two years of study was fun-filled but fruitful. We pushed each other to the limit, to you guys the sky is the limit. I will surely miss your company. Finally to my supervisor, Prof P.A. Botha. Thanks for believing in me, you pushed me to where I am now. Your support and supervision have been fantastic. In you, I learnt a great deal in as far as research is concerned. I am now confident that as I will take the next leg of my academic adventure, pursuing PhD, I will flow with ease. To the Graduate School staff, thanks for your administrative support. You made our stay and study easy for the past two years. Thanks for keeping up with us. iii ABSTRACT The study seeks to assess employees’ attitude, awareness of, participation in and satisfaction with the wellness management programme in the Department of Labour. The study was based on the fact that in addition to the implementation of the wellness management programme as a strategy to improve performance and assist employees in addressing performance problems which they encounter. Furthermore negative attitude, lack of awareness and low satsfaction levels amongst employees resulted in low participation level in wellness management programmes. The objective of the study was then to assess employees’ attitudes, awareness, participation and satisfaction regarding the wellness management programme of the National Department of Labour. The study used exploratory and descriptive designs, where, through an exploratory research design, the researcher assessed the degree to which employees are aware of the wellness management programme, and also explored strategies to be used to improve employee awareness, participation, and satisfaction. With the descriptive research design, the researcher described the current level of employee participation and satisfaction with the wellness programme. Data was collected through the use of a structured questionnaire, which was distributed as per selected sample. Date analysis was done through the use of descriptive statistics, independent samples t-test, ANOVA and the Pearson Product Moment Correlation. The findings of the study established that employees are aware of the wellness management programme and its various sub-programmes offered by the Department. The study further found that, besides the level of awareness, employees do not participate in the wellness management programmes. The study also established the employee’s attitude towards wellness programme is aligned towards the branch where an employee is based. Furthermore, satisfaction was significantly dependent on the age, occupational level and the branch where employees are based. The study concludes by recommending that the Department should develop a plan to enhance or improve employee participation, through satisfaction and their attitude, iv gender, occupational classification and the location of the branches within the department where employees are based needs to be considered in the planning and improvement of the wellness management programme. v TABLE OF CONTENTS CONTENT PAGE DECLARATION ..................................................................................................................... i DEDICATION AND ACKNOWLEDGEMENT ....................................................................... ii ABSTRACT ......................................................................................................................... iii GLOSSARY OF TERMS AND ACRONYMS ..................................................................... viii LIST OF TABLES ................................................................................................................ ix LIST OF FIGURES .............................................................................................................. xi CHAPTER 1: INTRODUCTION AND BACKGROUND OF THE STUDY ............................ 1 1.1 INTRODUCTION ........................................................................................................... 1 1.2 BACKGROUND OF THE STUDY ................................................................................. 3 1.2 PROBLEM STATEMENT .............................................................................................. 4 1.4 RESEARCH OBJECTIVES AND QUESTIONS ........................................................... 7 1.5 IMPORTANCE OF THE STUDY .................................................................................. 9 1.6 SCOPE AND ASSUMPTIONS OF THE STUDY ......................................................... 9 1.7 DEFINITION OF TERMS .......................................................................................... 10 1.8 PRELIMINARY LITERATURE REVIEW .................................................................... 11 1.9 RESEARCH METHODOLOGY ................................................................................. 14 1.10 STUDY LAYOUT...................................................................................................... 16 1.11 SUMMARY ............................................................................................................... 17 CHAPTER 2: LITERATURE REVIEW ............................................................................... 18 2.1 INTRODUCTION ......................................................................................................... 18 2.2 WELLNESS FROM A HOLISTIC PERSPECTIVE ...................................................... 18 2.3 CONCEPTUAL-THEORETICAL FRAMEWORK OF WELLNESS .............................. 20 2.4 THEORETICAL FRAMEWORK OF THE SIX DIMENSIONS OF WELLNESS ........... 22 2.5 ORGANISATIONAL WELLNESS PROGRAMMES .................................................... 37 2.6 EMPLOYEES AWARENESS AND ATTITUDES TOWARDS EWPS .......................... 44 2.7 EMPLOYEES’ PARTICIPATION IN WELLNESS PROGRAMMES ............................ 46 2.8 EMPLOYEES SATISFACTION WITH EWPs .............................................................. 52 vi 2.9 SUMMARY ................................................................................................................. 54 CHAPTER 3: RESEARCH METHODOLOGY ................................................................... 55 3.1 INTRODUCTION ......................................................................................................... 55 3.2 RESEARCH METHODOLOGY ................................................................................... 55 3.3 RESEARCH DESIGN ................................................................................................. 55 3.4 POPULATION AND SAMPLING PROCEDURE ......................................................... 56 3.5 DATA COLLECTION .................................................................................................. 57 3.6 MEASURING INSTRUMENT ...................................................................................... 57 3.7 VALIDITY AND RELIABILITY OF THE MEASURING INSTRUMENT ........................ 59 3.8 ADMINISTRATION OF QUESTIONNAIRE ................................................................. 60 3.9 PILOTING AND PRE-TESTING ................................................................................. 60 3.10 PROCEDURES FOR QUANTITATIVE DATA ANALYSIS ........................................ 61 3.11 RESEARCH ETHICS ................................................................................................ 62 3.12 SUMMARY ............................................................................................................... 63 CHAPTER 4: DATA ANALYSIS AND INTERPRETATION .............................................. 64 4.1 INTRODUCTION ........................................................................................................ 64 4.2 DESCRIPTIVE STATISTICS ...................................................................................... 65 4.3 DIFFERENCES IN THE EMPLOYEES' ATTITUDES TOWARDS AND SATISFACTION WITH THE WELLNESS PROGRAMME BETWEEN THE DEMOGRAPHIC VARIABLES 76 4.4 RELATIONSHIP BETWEEN EMPLOYEES’ ATTITUDES TOWARDS AND SATISFACTION WITH THE WELLNESS MANAGEMENT PROGRAMME ...................... 81 4.5 SUMMARY ................................................................................................................. 82 CHAPTER 5: DISCUSSION, RECCEOMENDATIONS AND CONCUSION ..................... 83 5.1 INTRODUCTION ........................................................................................................ 83 5.2 DISCUSSION OF FINDINGS ..................................................................................... 83 5.3 RECOMMENDATIONS............................................................................................... 88 5.4 DIRECTION FOR FUTURE RESEARCH ................................................................... 89 5.5 CONCLUSION ............................................................................................................. 90 LIST OF REFERENCES ................................................................................................... 91 vii APPENDIX A: RESEARCH QUESTIONNAIRE .............................................................. 102 ANNEXURE B : APPROVAL TO COLLECT DATA ........................................................ 109 ANNEXURE C: ETHICAL CLEARANCE ......................................................................... 111 viii GLOSSARY OF TERMS AND ACRONYMS ANOVA : Analysis of Variance CF : Compensation Fund COIDA : Compensation for Occupational Injuries and Diseases Act CS : Corporate Services DoL : Department of Labour DPSA : Department of Public Service and Administration EAP : Employee Assistance Programme EAPA-SA : Employee Assistance Professionals of South Africa EEA : Employment Equity Act EHW : Employee Health and Wellness EHWP : Employee Health and Wellness Programme ESSA : Employment Services of South Africa IES : Inspections and Enforcement Services LMI : Labour Market Information OHSA : Occupational Health and Safety Act PES : Public Employment Services SPSS : Statistical Package for Social Sciences UIF : Unemployment Insurance Fund WHO : World Health Organisation WLBP : Work-Life Balance Programme WMP : Wellness Management Programme ix LIST OF TABLES Table 2.1: Definition of dimensions of perceived wellness 21 Table 3.1: Cronbach’s Alpha Coefficients 59 Table 4.1: Employees’ attitudes towards the wellness management 70 Table 4.2: Employees’ awareness of the wellness management 71 Table 4.3: Information sources for creating awareness 72 Table 4.4: Employees’ awareness levels of wellness management 72 Table 4.5: Employees’ participation levels in the wellness management programmes 74 Table 4.6: Factors that will increase participation in the wellness management programmes 75 Table 4.7: Employees’ satisfaction with the wellness management 76 Table 4.8: Independent samples t-test to measure differences in the mean scores of attitudes towards the wellness management programme between males and females 77 Table 4.9: Independent samples t-test to measure differences in the mean scores of the satisfaction with the wellness management programme between males and female 77 Table 4.10: ANOVA to compare the perceptions between different age groups about attitudes towards the wellness management programme 78 x Table 4.11: ANOVA to compare the perceptions of employees between different occupational levels about the attitudes towards the wellness management programme 78 Table 4.12: ANOVA test to compare the perceptions of employees between different branches regarding the attitudes towards the wellness management programme 79 Table 4.13: ANOVA test to compare the perceptions of employees between different age groups about satisfaction with wellness management 80 Table 4.14: ANOVA to compare the perceptions of employees between different occupational levels about the satisfaction with the wellness management programme 80 Table 4.15: ANOVA test to compare the perceptions of employees between different branches regarding satisfaction with the wellness management programme 81 Table 4.16: Pearson product-moment correlation to measure the relationship between attitudes towards and satisfaction with the wellness management programme 82 Table 5.1: Difference in the employee’s attitude towards, awareness of, participation levels and satisfaction with wellness programme between demographic variables 96 xi LIST OF FIGURES Figure 2.1: Dimensions of Perceived Wellness Model 21 Figure 2.2: Conceptual framework for EHW in the public service 39 Figure 2.3: Wellness management Pillar 41 Figure 2.4: Factors contributing and barriers to employee participation 47 Figure 4.1: Gender 65 Figure 4.2: Age category 65 Figure 4.3: Race 66 Figure 4.4: Occupational Level 67 Figure 4.5: Educational Level 68 Figure 4.6: Branch 68 Figure 4.7: Number of work experience years in the Department 69 1 CHAPTER 1: INTRODUCTION AND BACKGROUND OF THE STUDY 1.1 INTRODUCTION Various institutions in both the private and public sector have realised the importance and positioning of the employee health and wellness programmes as vital instruments to motivate and retain their employees, enhance productivity levels, and to reduce the costs associated with absenteeism, presenteeism and attrition rate (Makgato, 2016:4). Makgato (2016:4) further indicated that the recognition of an employee health and wellness programme as a strategic tool is a result of organisations realising that they cannot succeed without healthy and committed employees (Makgato, 2016). Nel, van Dyk, Haasbroek, Schultz, Nsono and Werner (2004:293) defined employee wellness as an individual holistic approach in pursuit of improving his or her life, health and psychological strength, either as a community member or an employee of an organisation. Dawad (2014) also maintained that an employee health and wellness programme (EHWP) is a planned, systematic programme designed to provide professional assistance to all employees and their immediate family members, who experience, problems such as alcohol, drug, emotional or personal crises. In line with the argument by Dawad (2014), employees and their immediate family members benefit from assistance provided by the Employee Health and Wellness Programme seeking to ensure that their health and well-being are taken care of. In support of the argument, Pillay and Terblanche (2012:229) argued that, since workers spend most of their time and life in the world of work, it is vital for employers to recognise that their work cannot be separated from their personal and social lives, hence the importance of a work-life balance. The DPSA conceptualised the public service strategic framework on employee health and wellness in 2009, which prescribes the implementation of four (4) functional pillars, namely: HIV, STI’s and TB management pillar; the Health and Productivity management pillar; the Wellness Management pillar; and the Safety, Risk, Environment, Risk and Quality Management pillar. The functional programmes, therefore, provide direction to which EHW units in departments are to be structured. 2 The focus of the study is on the Wellness Management pillar. The pillar focuses mainly on the physical, psychological, organisational and work-life balance sub- pillars. DPSA (2009:14) pointed out that the Wellness Management Programme (WMP) in the Public Service was given priority because the health, safety and well- being of the employee have a direct impact on the overall performance and productivity of the organisation. The pillar acknowledges that staff members are the lifeline of the institution and, therefore, it is important that an organisation should implement programmes and initiatives which will assist them to produce at their optimum levels. Pillay and Terblanche (2012:34) is of opinion that the wellness management programme (WMP) has its basis in the Employee Assistance Programme (EAP) and the Work-Life Balance programme (WLBP). Pillay and Terblance (2012) further thought that traditionally, the EAP programme was geared towards supporting mainly individuals through counselling and provision of psycho-educational interventions, without consideration of other health-related matters, which could be contributory factors to psycho-social problems experienced by employees. Also, Pillay and Terblanche (2012:34) pointed out that the consideration of the work-life balance programme that institutions are implementing is a vital programme as they enable employers to accommodate employees’ personal lives and family needs and promote the requisite level of flexibility. That resulted in higher levels of employee satisfaction and motivation. It should be noted that wellness management seeks to enhance the well-being needs of staff members in both the public and private sectors by the implementation of various proactive and reactive programmes. This is made possible by improving several factors of the traditional EAP programme, such as employee counselling and work-life balance, to be in line with the facets of the wellness management, which are most relevant, topical and appropriate to address the requirements of the new public sector workforce (Pillay & Terblanche, 2012:34). Wellness Management is, therefore, an interventional strategy with the aim of promoting the well-being of workers. Sieberhagen, Pienaar and Els (2011:21) asserted that the purpose of introducing a wellness programme in an organisation is 3 to create an awareness of wellness issues, to facilitate personal change and health management and to promote a healthy and supportive workplace. While the intention of the wellness management programme is clearly outlined, it is vital for an organisation to determine if the programme is effective in meeting its intended purpose, and also if employees are utilising it. Hence, the proposed study is aimed at assessing the knowledge, awareness, attitude, behaviour practices, and satisfaction of employees regarding the health and wellness programme in the National Department of Labour’s Head Office. 1.2 BACKGROUND OF THE STUDY According to the DoL (2016:3), the Department subscribes to the vision that strives for a labour market that is conducive to investment, economic growth, employment creation and decent work. In achieving the vision as outlined, the Department of Labour is well positioned to provide regulatory machinery to the South African labour market. It aims to ensure sustained economic growth, through its various legislative prescripts, which aims at enforcing and regulating labour and employment practices, such as inspection and enforcement services; compliance monitoring; protection of vulnerable workers; creation of employment opportunities; promotion of equity and social and income protection. The Department of Labour has a responsibility of executing its key mandates in regulating the labour market through policies and programmes conceptualised and adopted in consultation with various social partners through NEDLAC. DoL (2017) asserted that the implementation of the key mandates is guided by the following legislative prescripts:  Payment of Unemployment Insurance Fund is guided by the Unemployment Insurance Act 30 of 2001;  Payment of compensation for occupational injuries and diseases in line with the Occupational Injuries and Disease Act 130 of 1993 (COIDA);  Inspections and Enforcement Services has guided the following Acts: o Occupational Health and Safety Act (OHS) 85 of 1993 o Employment Equity Act 55 of 1998 as amended (EEA) 4 o Labour Relations Act 65 of 1995  Creation of decent work, which is guided by the International Labour Organisation and locally through the Employment Services Act (ESSA) 4 of 2014. The Department of Labour has a staff complement of 8 069 employees spread across all 9 Provincial Offices, 145 Labour Centres, and the Departmental Head Office and Head Offices of the UIF, the CF and the SEE. The Department of Labour has been implementing the Programme since 2001 at the point when it was still the Employee Assistance Programme. In the year 2009, the Department started implementing the integrated employee health and wellness programme in line with the EHW strategic framework for the public service. DoL (2016:45) pointed out that the implementation of the EHW programme is through a centralised model where wellness practitioners are based at Head Office with the responsibility of programme implementation at all offices of the Department. 1.3 PROBLEM STATEMENT The Department of Labour, just like any other public service institution, is faced with challenges relating to human resources, such as significant evidence regarding the burden of disease attributable to workplace environment, and non-communicable diseases, absenteeism, low morale, critical common risk factors, such as substance abuse, unhealthy diets, physical inactivity, stress, family problems, accidents, financial problems, trauma and communicable diseases such as HIV and AIDS and TB. The translation of the challenges experienced proves that the Department incurs financial loss as a result of the negative impact of the problems on individual employee job performance. The wellness management policy of the Department outlines the purpose of the programme, being to implement interventions which are both proactive and reactive to ensure the wellness of employees. Besides the availability of the wellness management programme and interventions which are implemented to assist the Department to address various problems, the challenges persist and result in 5 situations where much time is committed to solving the problems through the use of measures such as corrective disciplinary procedures aimed at assisting employees to manage interpersonal problems. Of significant concern is that, over the years, the Employee Health and Wellness Unit has recorded a very noticeably low uptake of various wellness management services by employees of the Department, particularly at Head Office, where EHW practitioners are accessible at all times. It is worth noting that the wellness management case statistics and reports dating back from the year 2013 to 2016 show that different interventions such as proactive and reactive services are being implemented to address cases of poor performance and to improve levels of productivity by employees. However, the initiatives are not keenly taken as productivity enhancers, primarily because they do not enjoy the expected uptake and utilisation by employees at all levels. Effective utilisation is affected by various factors such as participation, employee attitude, awareness of the programme and satisfaction with the programme. According to Edwards (2012:39) employee participation is regarded as an important factor in the success or failure of the employee wellness programmes, and it is therefore vital for managers to maximise employee participation in wellness activities and programmes. Kolacz (2015:30) maintained that a workplace wellness programme is normally voluntary, and as such, there is no prescriptive legislation that requires employees to participate. Kolacz (2015) further pointed out that there are several factors at the individual, social and organisational levels which affect or contribute towards employee participation in wellness programmes. Such factors include demographic indicators, perceived health status and perceived stress, organisational climate, job flexibility, support by colleagues and supervisors’ support. Some of the barriers to participation which affect employee participation in wellness programmes are lack of time, commitment, lack of self-efficacy, inconvenient scheduling and lack of trust in the programme. Participation of employees in wellness programmes is also influenced by the attitude and awareness of employees towards the programme. Sieberhagen et al. (2009:4) claimed that where employees do not have a positive attitude towards the programme, uptake is greatly affected in that they will view the programme as a “by the way”. Sieberhagen et al. (2009) further cautioned against employers placing 6 more emphasis on implementing the programme with a view to reducing costs and increasing productivity, since that leads to more emphasis being placed on making profit as a key output and the well-being of employees being given little regard, since more often than not employees become aware of that and therefore they tend to develop a negative attitude towards the programme. Lassen, Bruselius-Jensen, Sommer, Thorsen and Trolle (2007) postulated that the key to developing a positive attitude in employees towards the programme is prevalent of trust, confidentiality and ethical values in an organisation. These are critical issues that employees consider when it comes to participating in wellness programmes. However, if employees feel or perceive that there is a lack of such things, they will not participate whole- heartedly, but if they do engage, they will do so just for the sake of it and, hence, might not derive full benefit from it. Employee attitude, knowledge and participation in the programme are influenced by the rate at which employees are satisfied with the programme. Robroek, Van Lenthe, Van Empelen and Burdorf (2009) argued that employee satisfaction is a term that is used to describe if employees are satisfied or fulfilled with their needs and desires in an organisation. Accordingly, what contributes to employee satisfaction becomes a factor in motivating employees to achieve organisational goals to instil positivity, and boost employee morale. In essence, employee satisfaction is the combination of the effective reaction to the various perceptions of what an employee expects to receive, as compared to what the employee actually received. Batorsky, Taylor, Huang, Liu and Mattke (2016) suggested that satisfaction with wellness programmes is derived from the fact that the employer can provide wellness services which meet the expectations of employees. In a study conducted by Batorsky et al. (2016), the majority of the respondents (61%) were dissatisfied with employee wellness programmes, where they do not believe that the employer has clear and good intentions for meeting the needs, which on its own is a contributor to low participation in the programme. It is important to note that where employees believe that wellness programmes improve their health and well-being, they are highly likely to be satisfied, hence one should also realise the increase in uptake and participation. Various employers have developed a strong business case which seeks to improve the overall health and well-being of their employees, as a 7 result of the realisation that employees whose health and well-being are compromised, happen to miss twice as many days from work as compared to those who are healthy (Robroek et al., 2009). Batorsky et al. (2016) claimed that most employers prioritise providing medical benefits to employees rather than providing effective wellness programmes; hence employee satisfaction levels would be affected. This is as a result of the view and attitude which employees develop, which seem to suggest that employers are only interested in improving productivity and profit margins. For this study, the following problem statement has been formulated: The low participation levels by employees in the wellness management programme could be attributed to a negative attitude, a lack of awareness, and low satisfaction levels among employees regarding the wellness management programme. Therefore, this study is aimed at assessing the employees’ perceived attitude towards awareness, participation and satisfaction with the wellness management programme (WMP). It is against that background that lack of appreciation of the current status of the programmes being implemented should be seen. It will be difficult to determine and develop goals for the future. 1.4 RESEARCH OBJECTIVES AND QUESTIONS 1.4.1 Research Objectives The central and primary objective of the study is to assess employees’ attitudes, awareness, participation and satisfaction regarding the wellness management programme of the National Department of Labour, Head Office. More specifically, the study aims to:  determine employees’ attitudes towards the wellness management programme;  determine employees’ awareness of the wellness management programme; 8  investigate the extent to which employees participate in the wellness management programme;  measure employees’ satisfaction with the wellness management programme;  determine the relationship between employees’ attitudes towards and satisfaction with the wellness programme; and  suggest remedial strategies that can be fundamental in improving the wellness management programme in the Department. 1.4.2 Research Questions Bryman and Bell (2015:88) intimated that research questions are important, since guiding a researcher in finding relevant information as part of their literature review and decision-making about the type of research to be undertaken, and the method to be used to collect and analyse data, they also assist in determining how the research report should be compiled in a systematic manner. In pursuit of achieving the objectives of the study, the following research questions will be answered:  What are the employees' attitudes towards the wellness management programme, awareness of, participation levels in and satisfaction with the wellness programme?  Are there differences in the employees' attitudes towards, awareness of, participation levels in and satisfaction with the wellness programme between the demographic variables?  What is the relationship between employees’ attitudes towards and satisfaction with the wellness programme?  What remedial intervention strategies can be suggested and implemented to improve the wellness management programme in the Department? 9 1.5 IMPORTANCE OF THE STUDY The study is important in that it will assist departmental management with the following:  Understand the employees’ attitudes towards the wellness management programme  Understand the extent to which employees are utilising the wellness management programme  Understand the reasons employees either take up or do not take up services offered by the Wellness Management programme to provide guidelines to make the programme effective and to render the programme more cost- effective  Develop and implement appropriate strategies based on empirical findings to improve programme utilisation and effectiveness. The study will benefit the employees because the perceived wellness assessment will provide them with an overview of their wellness status. Furthermore, it will unearth the ambiguities and deal with the concerns of employees about the programme. This would result in a tailor-made programme specifically to address the needs of employees through the wellness management programme. Finally, the programme will benefit the employees in the sense that it will come up with suggestions and recommendations of strategies that the Department can implement to improve or make the programme more effective and eliminate the challenges currently encountered by the programme. 1.6 SCOPE AND ASSUMPTIONS OF THE STUDY 1.6.1 Scope of the study The focus of the study will be on the National Department of Labour, Head Office, Pretoria, and the unit of analysis is categorised as follows:  Top Management (L15-16)  Senior Management (L13-14)  Middle Management (L11-12)  Junior Management (L9-10) 10  Supervisors (L7-8)  Lower level and Administrative Staff (L3-6) 1.6 Assumptions The following are the assumptions which the study seeks to prove through a literature review and data collected using the primary data collection method:  Employee knowledge and awareness have a way of influencing their participation and uptake of the Wellness Management Programme.  Employee attitude and awareness have an impact on their utilisation, satisfaction and effectiveness of the Wellness Management Programme. 1.7 DEFINITION OF TERMS 1.7.1 Wellness The DPSA (2009:31) stated that wellness is a state of health of both an individual and group of individuals with the main point of concern the achievement of the individuals’ potential to strike a balance between various dimensions of wellness, being psychological, social, spiritual, physical, intellectual and emotional, thereby enabling an individual to fulfil his or her role and expectations as a member of the family, community, and the world of work. 1.7.2 Employee wellness programme Berry, Mirabito and Baun (2010: 12) defined an employee wellness programme as a well-organised programme, which is systematically run and financed by the employer, with the sole purpose of assisting employees and their immediate family members to enable them to adopt a specific behaviour, which helps to reduce health and behavioural risks, improve quality of life, and ultimately improve their effectiveness and productivity. 11 1.7.2 Employee assistance programme (EAP) EAPA-SA (2010:10) claims that EAP is a workplace programme designed with the clear intention of assisting employees to identify and resolve performance impairing problems, which include issues such as personal and organisational concerns, with the potential of affecting their productivity and job performance. 1.8 PRELIMINARY LITERATURE REVIEW The preliminary review will focus on the construct wellness and employees’ perceived attitudes, awareness and participation in a wellness management programme. Rothmann and Ekkerd (2007:1) maintained that perceived wellness is a sense that one is living in a manner that allows for the experience of consistent, balanced growth in the various dimensions of wellness, which includes the emotional, intellectual, physical, psychological, social and spiritual dimensions. Furthermore Adams, Bezner, Garner and Woodruff (1998:217) also asserted that by definition, individuals who score highly on the perceived wellness scale should be more physically healthy; have a greater sense of meaning and purpose in life; expect that positive things will occur in their lives, no matter what the circumstances; be more connected with family or friends; be more secure and happy with whom they are, and be intellectually vibrant. As a starting point, it is essential to try and understand the employee’s attitude towards wellness programmes. Such understanding will then assist in developing employee programmes that employees want and will participate in, instead of what the Department perceived to be required by employees. Bright, Terrell, Rush, Kroustos, Stockert, Swanson and DiPietro (2012:21) stated that many organisations have implemented wellness programmes to reduce costs on the one hand, and on the other hand improving productivity, which often results in improved profitability as a primary focus and the well-being of employees being the secondary focus. Employees are mostly aware of this approach, which might explain why they do not have a positive view of wellness programmes. Hence, in most cases, such objectives are not realised as a result of employee attitudes towards the programmes. 12 In support of the argument by Bright et al. (2012:21), it is vital to understand that what builds a positive attitude and positive view towards wellness programmes is the combination of trust, confidentiality and adherence to ethical considerations by the organisation. Such aspects are very critical and are seriously considered by employees when they opt to participate in wellness programmes. However, if the employees feel that the service provided does not conform to the expected standards, they will either not participate or not participate whole-heartedly. The employee’s attitude and perceptions towards the wellness programme contribute towards the effectiveness of the workplace programme. This is supported by Sangweni’s (2006:56) argument that when employers make efforts to raise awareness about the programme, employees easily get to understand its intentions, thereby increasing its uptake and level of productivity. Nicolaas (2007) maintained that in cases where employees do not have sufficient knowledge and awareness of the programme, it leads to the development of negativity towards the programme. Therefore it is vital that the employer should focus more on creating awareness about the programme in order to increase its uptake and the perception about it. Lassen et al. (2007) pointed out that employees tend to experience increased self- worth and confidence after they have participated in various wellness programmes. Employers could ensure that employees are aware of the various wellness programmes on offer, through the use of various means of raising awareness, such as regular communication, use of social media to promote the programmes, supervisory referrals and also as part of the new employee induction. Makgato (2016:36) maintained that participation in a wellness programme is a key variable that can have an impact on the effectiveness of the programme. It is therefore incumbent on the employer to encourage participation and to remove barriers to effective participation by employees. Klautzer, Mattke and Greenberg (2012:268) claimed that some companies have been more successful than others in encouraging participation of employees in wellness programmes through the number of efforts that they put in the implementation of their programmes. Ensuring employee participation is coupled with the resources, time and management support and buy-in which results in a solid investment in wellness initiatives. 13 Klautzer et al. (2012:268) further pointed out that companies that positively influence its workforce to participate in wellness programmes do so by demonstrating a culture that seeks to say wellness is for all employees, regardless of level. Such companies further ensure that there is a promotion of wellness and they inculcate the culture of employees seeking to make health-related choices during the workday. In the study conducted by Beck, Hirth, Jenkins, Sleeman and Zhang (2016:2), it is estimated that about half of the employees completed the Health Risk Assessment or participated in clinic screenings as part of the workplace wellness programmes. Beck et al. further found that the reasons for participation or non-participation in wellness programmes vary significantly from one individual to the other. In some instances, concerns related to the selection bias in programme participation are cited. The study also found that there is generally higher participation in wellness programmes by women, younger employees, more educated employees, those who perceive benefits in wellness and those exhibiting high levels of self-efficacy. Beck et al. (2016:3) argued that while most companies are enjoying high participation rates, some are experiencing barriers that include factors related to time, interest, convenience, and specific wellness benefits. They further suggest improving participation; employers should consider the use of various methods such as incentives, the involvement of employees in programme design, and management support and buy-in (Beck et al., 2016). It should also be noted that employee attitude, knowledge and participation in the programme are influenced by the rate at which employees are satisfied with the programme. Robroek et al. (2009) maintained that employee satisfaction is a term which is used to describe if employees are satisfied or fulfilled with their needs and desires in an organisation. Accordingly, what contributes to employee satisfaction becomes a factor in motivating employees to achieve organisational goals to instil positivity, and boost employee morale. In essence, employee satisfaction is the combination of the effective reaction to the various perceptions of what an employee expects to receive, as compared to what the employee received. Beaton (2017) contended that satisfaction with wellness programmes is derived from the fact that the employer can provide wellness services which meet the 14 expectations of employees. In a study conducted by Batorsky et al. (2016) the majority of the respondents (61%) were dissatisfied with employee wellness programmes, where they do not believe that the employer has clear and good intentions of meeting the needs, which on its own is a contributor to low participation in the programme. It is important to note that where employees believe that wellness programmes improve their health and well-being, they are highly likely to be satisfied, hence one will also realise the increase in uptake and participation. Various employers have developed a strong business case, which seeks to improve the overall health and well-being of their employees as a result of the realisation that employees whose health and well-being are compromised, happen to miss twice as many days from work as compared to those who are healthy (Robroek et al., 2009). Batorsky et al. (2016) suggested that most employers prioritise providing medical benefits to employees instead of providing effective wellness programmes; hence employee satisfaction levels would be affected. This is as a result of the view and attitude which employees develop which seem to suggest that employers are only interested in improving productivity and profit margins. 1.9 RESEARCH METHODOLOGY 1.9.1 Research Design Bryman and Bell (2015:40) advanced the idea that research design provides a blueprint according to which data will be collected and analysed, and further that a selection of the research design reflects the decision about the priority being given to a range of dimensions of the research process. The researcher selected an option of a cross-sectional survey design which addresses the various dimensions of the study. According to Bryman et al. (2015:105), a cross-sectional design is associated primarily with social surveys, but also covers various research methods, that include structured observation, content analysis, official statistics and notes or records. Based on the fundamental principles of a cross-sectional study, the researcher has used a self-administered questionnaire to collect data. The researcher used a self- 15 administered structured questionnaire, with adapted constructs from the study conducted by Walters (2015). 1.9.2 Population and sampling Welman, Kruger and Mitchell (2007:52) pointed out that the population is the study object which comprises individuals, groups, and organisations. Non-probability sampling was used, where purposive sampling was considered. Bryman et al. (2015:186) stated that the goal of purposive sampling is to sample cases/participants strategically so that those sampled are relevant to the research questions. The researcher has used purposive sampling where the sample obtained is regarded as being representative enough to provide information about the study. The sample was also purposefully selected from the perspective and experience of respondents and added value to the issues being researched. Moreover, consideration was also given to the fact that the unit of analysis is therefore relatively not significant in pursuit of eliminating errors; the researcher has considered 60% of the unit of analysis as a sample size. Therefore N= 478. The units of analysis or study subjects are located at the departmental Head Office in Pretoria. 1.9.3 Data analysis Bless et al. (2006:163) maintained that upon finalisation if the collection of data and its verifications have been completed, the process of analysing such data should continue. The main purpose of conducting data analysis is to enable the researcher to detect patterns which are consistent within the set of data being analysed. 1.9.4 Quantitative data analysis The following methods of data analysis were used:  Descriptive statistics were used to describe study elements, being employees’ perceived wellness behaviour, attitudes, awareness, participation and satisfaction through descriptive statistics. The elements of the study 16 mentioned above were also analysed, using the Likert scale-based questions, ranging from strongly agree and strongly disagree, whereas some required a yes or no type of answer.  Independent samples t-test - the purpose of the t-test is to compare the average responses of two populations. Samples are selected randomly from these populations and the variances of the population, whose responses are assumed to be equal.  ANOVA - the purpose of the ANOVA test is to compare the average responses of more than two populations. Samples are selected randomly from these populations and the variances of the population responses are assumed to be equal.  Pearson product moment correlation – the purpose of the Pearson product moment correlation is to determine the relationship between employees’ attitude and satisfaction with the wellness management programme. The SPSS version 25 was used to analyse quantitative data. The SPSS provided the researcher with a statistical summary of data collected in the form of descriptive statistics, which was interpreted. 1.10 STUDY LAYOUT The following constitute the chapters of the study: Chapter 1 Overview of the study The chapter introduces and provides a background of the study, outlining purpose and objectives, presenting the research problem that serves as the basis of the study, complemented by the research questions, which the study aims to answer. The chapter also delineates the assumptions and scope of the study, including the importance and delimitations. 17 Chapter 2: Literature review The chapter focuses on a literature review, with specific emphasis on literature relevant to the study, particularly on the constructs of wellness, employee participation, attitudes, awareness, and satisfaction with the wellness management programme. The chapter also unpacks the relevant theory related to the study. Chapter 3: Research methodology and design The chapter outlines and discusses the methodology used in the study, which includes aspects such as research methods, research design, study population and sampling procedure, data collection, data analysis and ethical considerations. Chapter 4: Data analysis and results The chapter presents the results based on the data analysis. Chapter 5: Discussion of main findings, recommendations, and conclusion In this chapter, the focus is on presenting main findings, advancing key recommendations to deal with gaps in line with the constructs of the study and draw conclusions, which will include a proposal for further studies. 1.11 SUMMARY The chapter outlined the purpose of the research, objectives, and aims. It further detailed the background and a problem statement of the research, which is based on the study of the National Department of Labour. The chapter discussed the literature review to outline, define, and discuss the core concepts of the study. It further detailed the structure of the research paper in the outline of chapters. 18 CHAPTER 2: LITERATURE REVIEW 2.1 INTRODUCTION The chapter’s focus is to review various studies relating to different aspects of employee health and wellness as they are in line with the objective of the study. This chapter focuses specifically or more directly and in detail, on the wellness management pillar and its various dimensions. The chapter further outlines and discusses the importance and benefits of wellness management in an organisation; effectiveness of a wellness management programme; utilisation and barriers of effective utilisation of the programme; employee perception and attitudes towards the programme as drivers towards its effective implementation and utilisation; perceived wellness, and it concludes by discussing the legislative framework that governs and promotes the effective roll-out of employee health and wellness programmes. 2.2 WELLNESS FROM A HOLISTIC PERSPECTIVE According to Miller and Foster (2010:5), holism is a concept in the field of health and wellness that came into being from the approach, which was applied by scholars and researchers to understand the multifaceted facts such as organisms and ecosystems and a movement in society towards a worldview that is more holistic and relational. Miller and Foster (2010:5) further have the view that the term wellness could be seen as part of a process in defining health towards a holistic perspective that is inter- relational and positive in focus. Miller and Foster (2010:5) aver that as part of the history on the holistic wellness perspective, its importance was recognised after the Second World War, largely because of the change in the health needs of society. Ryff and Singer (2006) further argued that as a result of the advancement of technology in the field of health, it meant that treatment of infectious diseases improved. Therefore cases of death owing to infectious diseases reduced considerably. The focus, however, has to shift towards addressing chronic and lifestyle diseases such as cancer, high blood pressure and diabetes, which are commonly associated with stressors in life and equally at work. With time and the evolution of wellness, it became apparent that more should be done to increase the 19 state and level of wellness of people at work by promoting physical, mental and social activities. Ryff and Singer (2006) emphasised the need to incorporate the various dimensions of wellness in enhancing the overall well-being within the workplace, which includes intellectual, physical, social, emotional, occupational, and spiritual dimensions. In support of the holistic perspective of wellness by Miller and Foster (2010), the WHO (2006) views wellness as being holistic, with an absence of illness and a good state of well-being as being vital for each individual. It is important to note that besides the fact that the WHO holds this view of wellness, costs related to health care are on the increase, because of various lifestyle diseases. Therefore, it is crucial that actions should be taken to determine factors that could contribute to well- being, particularly in the workplace. One of the key steps that employers need to recognise and implement is to ensure a policy-friendly environment that will best support the health and wellness of employees. Because of the advent of policies, employers will better conceptualise and define clearly what would constitute a healthy working environment that will contribute to employee well-being. Kister, Van der Walt and Viljoen (2009:3) maintained that the accurate and appropriate definition and conceptualisation of wellness are where employers viewed individuals within a holistic perspective and recognised that what constitutes well- being is the various dimensions of wellness which should be embraced. Kister et al. (2009) further articulated that the biomedical model that had its focus purely on the treatment of ailments should align with other models that are leaned towards the holistic approach since wellness includes various aspects such as the mind, body, spirit, and social interaction. These primary aspects constitute the various dimensions of wellness and are interconnected. It should be noted that wellness is promoted to ensure that employees are assisted to alleviate and deal with illness and health risk challenges through various proactive programmes, such as physical activities, an awareness campaign, psycho- educational and other targeted interventions (Miller & Foster, 2010:57). Adams, Benzer and Steinhardt (1997), in their study of perceived wellness, defined wellness from a system approach point of view, where all subsystems have their own 20 elements and each is considered an important element of the broader system. Adams et al. (1997) further defined wellness as a leaning towards the health aspects, but further stressed the need to include various factors such as social, environmental, and cultural influences from the system perspective. Furthermore, they included the psychological wellness as another dimension that relates to the positive outcome in response to the well-being of an individual. 2.3 CONCEPTUAL-THEORETICAL FRAMEWORK OF WELLNESS The theoretical model of wellness is based on the Perceived Wellness Model by Adams et al. (1997). Rothman and Ekkerd (2007:1) defined perceived wellness as the sense that an individual is living in a manner that allows for an experience that is consistent with balanced growth in various dimensions of wellness, being emotional, intellectual physical, psychological, social and spiritual aspects. Adams et al. (1997:217) asserted that individuals who obtain higher scores on a perceived wellness scale should be more physically healthy, have a greater sense of meaning and purpose in life, expect that positive things will occur in their personal lives, be more connected and in touch with family, be more secure and happy with who they are, and also intellectually stimulated. Perceived wellness could also be defined as a point where an individual lives in a space that allows for equilibrium regarding the development and growth of all dimensions that constitute well-being (Adams et al. 1997) maintained that perceived wellness behaviour levels are grounded on the basis that it is essential to rely on individual, “own” thinking and views when undertaking the study of wellness. The perceived wellness model by Adams (1997) has its roots and basis in the systems theory and salutogenic foundation. Accordingly, because of the systems theory, each feature of the system is equally an important sub-element of a larger system and a self-regulating system with its own sub-elements, hence the perceived wellness model is constituted of various elements and sub-elements. Furthermore, elements of the systems theory are equally organised in such a way that disruption of their interconnectedness at any stage would require revision of the entire system. Based on the perceived wellness model, as depicted in figure 2.1, wellness includes a cohesive mode of operation, signifying a two-way integration of the system. At a personal level, this implies concurrent operation of various dimensions and at different levels within them. 21 Figure 2.1: Dimensions of Perceived Wellness Model by Adams et al. (1997) Adams et al. (1997) highlighted that wellness professionals should focus on the salutogenic pole of each dimension, as depicted by various points of figure 2.1, in pursuit of measuring wellness perceptions that normally go beyond noticeable symptoms. The various dimensions of wellness, as depicted in figure 2.1, are defined in detail in table 2.1 below. Table 2.1: Definition of dimensions of perceived wellness by Adams et al. (1997) Component of Definition a findings Wellness Physical A positive view and anticipation or physical health. Spiritual A belief in the sense of unity between mind and body or a positive perception of meaning and purpose in life. Psychological A general view that one will experience positive outcomes to the events and circumstances of life. Social The view of having support available from family or friends in times of need and the view of being a valued support provider. 22 Component of Definition a findings Wellness Emotional The possession of secure self-identity and a positive sense of self-regard. Intellectual The view of being internally energised by an optimal amount of intellectually stimulating activity. The information in table 2.1 reflects how positive or balanced perceived wellness behaviour levels of an employee should be cutting across the dimensions of wellness. The information also represents how an employee who scores higher on a perceived wellness scale should be regarding the various dimensions of a wellness management programme and is discussed in detail under the theoretical framework. 2.4 THEORETICAL FRAMEWORK OF THE SIX DIMENSIONS OF WELLNESS This section will focus on the theoretical framework, with particular emphasis on the six dimensions of wellness that include social, physical, psychological, intellectual, emotional and spiritual dimensions. The section will further focus on the risk factors for lack of any of the dimensions at an individual and organisational level and conclude by advancing recommendations on improving the implementation of each dimension. 2.4.1 Social Wellness Miller et al. (2010:14) advanced the idea that the social dimension of wellness takes into cognisance the extent to which people interact with one another within society and also the environment. It also recognises that level at which individuals work towards supporting the community and the environment through their day-to-day actions. Renger et al. (2000) declared that when individuals get on with others, can express how they feel and are supportive, thus building fulfilling relationships, which constitutes the social aspects of the dimension. Helliwell (2005:4) confirmed that there is a vital significance in the relationship between the quality of life which one leads, and the type of the social network which an individual keeps, more specifically the family. Helliwell further stated that the relational styles are determined by the attitude that a person has towards relationships. 23 Ryff and Singer (2006) suggested that, based on epidemiological findings, mortality is relatively lower amongst individuals who have strong social connections and that aspects of social connectedness include the size of a person’s social network and the rate at which a person keeps contact with his/her social network. Durlak (2000) included, as part of the social networks of individuals, aspects such as acceptance by peers, bonds and attachments which one develops with others and social skills which range from communication to conflict resolution. These aspects are considered as being important components that constitute social wellness. Social wellness in its scope includes the way in which an individual relates and interacts with other individuals in society, with nature and also relationships at work. Therefore, the quality of these relationships could either be affected or developed and nurtured by motivation, action, perception and intention of an individual with others. Low-level social wellness results in social isolation, which according to Olufemi (2017:1), refers to a situation where an individual does not have a sense of social belonging, does not have proper or no engagement at all with other individuals, and has a minimal social network that is sufficient to fulfil and constitute quality social relationships. Lack of social wellness could also be viewed as a pathway to either emotional or psychological disorders that individuals might experience. Therefore, social interactions and relations are essential to the well-being of individuals to ensure sustenance of physical, emotional, and psychological health. It is worth noting that, as human beings, we are expected to socialise with others within the community and society, therefore isolating ourselves could have negative repercussions on our health in general. It is therefore vital that people should be encouraged to keep in constant contact with their social circles that include friends and family. Wellness education could be considered an essential and sufficient strategy to improve wellness behaviours of people. Witmer and Sweeney (1992:3) posited that a high level of wellness behaviour is improved and enhanced by ensuring availability and implementation of policies and programmes geared towards acceptable levels of social capital in the workplace. They further argued that more structural approaches would ensure that the workplace creates an atmosphere and approaches that 24 promote behaviour modification. Such approaches could include the following: strengthening social networks in the workplace, which could be achieved through team building; building social and labour oriented organisations, such as recognised labour unions; and building strong community linkages aimed at bringing together groups which are normally divided along racial, religious, ethnic or class differences. Hawe and Shiell (2000:879-880) emphasised the need for and significance of creating strong emtional and social ties by ensuring that the workplace is conducive and promotes a sense of community, and that capacity building initiatives are prioritised to empower employees through a process of awareness and training to foster development of skills to enable employees to recognise and understand their role in changing their social setup. Cohen-Mansfield and Peach (2015:5) suggested that it is possible to deal with the challenges of social isolation and enhance social wellness through various wellness educational programmes, which emphasise the maintenance of social networks. In a study by Robins, Jansons, O’Brien and Haines (2017) it was suggested that the promotion of physical activity as an intervention could improve social wellness in the workplace and also in the community. It is also noted that physical activities are one of the most effective ways of improving health in individuals and its also helps in improving psychosocial health. 2.4.2 Intellectual wellness Naz, Rehman, Katpar and Hussain (2014) advanced the idea that intellectual wellness is associated with the extent to which an individual engages in creative activities that are stimulating, as well as the use of available resources to develop and enhance knowledge to focus on the application and articulation of critical thinking and reasoning. Naz, et al. (2014) disclosed that intellectual wellness represents lifelong learning, coupled with purposive efforts to share expertise and experience with others, and the ability to harness skills and capabilities to achieve a more satisfying life. Myers et al. (2005) declared that the cognitive and psychological relationship between intellectuals presents the two aspects of being closely related and affecting each other, thereby lack of intellectual wellness could result in a deficit in psychological wellness and vice versa. 25 Renger et al. (2000) also believed that intellectual wellness is one’s orientation and achievement toward personal growth, education, achievement, and creativity. This encompasses awareness and participation in cultural events and exploiting available opportunities to gain and share expertise and understanding of local and international events alike. Naz et al. (2014) further declared that developing intellectual wellness is also enhanced by reading, studying, travelling, and exposure to various aspects. Miller et al. (2010) also pointed out that intellectual wellness is the level of education and learning which is comprehended by mental status, cognitive style and flexibility and attitude towards learning. Durlak (2000) further argued that development of talent and abilities entails learning how to constitute higher order reasoning skills in intellectual wellness. Durlak (2000) further maintained that the problem areas in intellectual wellness include underachievement, anxiety, and failure to complete certain or specific tasks. Case and Paxson (2006) intimated that other challenges associated with lack of intellectual wellness are compromised levels of academic achievements that are likely to contribute to job dissatisfaction and security, thereby contributing to reduced quality of work-life. It should also be noted that low levels of literacy are also associated with poor health and hygiene, whereby individuals with no educational attainment or low educational levels are extremely likely to engage in unhealthy practices, such as substance abuse, eating an unbalanced and poor diet, which results in weight gain and development of lifestyle diseases. It is therefore important to ensure that a certain level of intellectual wellness is stimulated amongst employees. That will assist in ensuring shared critical reasoning, performance enhancement, target achievement job security succession planning, employee turnover reduction and improvement of skilled labour force retention. 2.4.3 Physical wellness Ryff and Singer (2006) claimed that physical wellness lies in improving the fitness of an individual which, in turn, boosts his/her cardiovascular flexibility and strength. Therefore, steps taken in the improvement of physicality should include developing and sustaining an exercise schedule and sticking to a well-balanced diet, and a system where an individual will be able to monitor and develop an awareness of their 26 reaction to stress at both internal and external levels. That will assist an individual to be in a position to seek medical care at an appropriate time and to take proactive and preventive actions to alleviate harmful behavioural practices. It is worth noting that sustained training and exercise is regarded as vital to our physical health and well-being. However, people still do not engage in it. It is therefore important to encourage and inculcate the spirit and culture of people practising physical activities on a regular basis, as it is associated with greater benefits towards the physical, psychological, and physiological aspects of human beings and plays a vital role in preventing a variety of illness, particularly lifestyles diseases. Ohuruogu (2016:123) further supported the argument above, where he indicated that most people are fully conscious of the outcomes and results of sustained physical training and exercise programmes about health and well-being, and that lack of physical fitness is the key contributory factor towards poor health. Olubayo-Fatregun et al. (2014:33) further maintained that being physically fit contributes towards health and well-being in various ways, which include helping in preventing communicable diseases or lifestyle diseases. Furthermore, it assists with treatment or prevention of illness where regular physical activities have demonstrated to be an essential factor in reducing symptoms such as stroke, back pain and muscle spasms; it also acts as part of promotion of health and wellness benefits in the workplace, since physical activities contribute towards the promotion of quality work life. Various studies and researchers have confirmed that there is a relationship between sedentary lifestyles and both mortality and morbidity. A study by Gonzalez, Fuentes and Marquez (2017) documented that low levels of physical fitness and activity are associated with increasing levels of mortality. They further asserted that a sedentary lifestyle has a high potential of leading towards chronic conditions, including lifestyles such as cancer, cardiovascular diseases, stroke, diabetes and hypertension. Furthermore, inactive people are also at higher risk of various forms of cancer such as colon and prostate cancer (Gonzalez et al., 2017). Robins et al. (2017) maintained that there are several types of cardiovascular diseases, with some identified as coronary heart diseases, in that they affect the heart muscles. Gonzales et al. (2017) further asseverated that adults who reduced 27 the relatively higher number of calories per week in strenuous sports had reduced the risk of coronary heart disease. Improving activity levels is deemed as being amongst the best methods of reducing heart disease amongst adults. Besides the physical health risk, obesity is also associated with psychological risks. Gibbs, Hergenroeder, Katzmarzyk, Lee and Jakicic (2015:12) disclosed that obese women have a slightly higher rate of depression than normal-weight women. This is because they are exposed to harsh treatment in the workplace that relates to prejudice and discrimination at all stages of employment. Gibbs et al. (2015:13) further divulged that from an economic perspective, an employee who is obese is more likely not to be present on duty due to various health and wellness-related issues. As such, it has a negative influence on productivity both at individual and organisational levels. Zhang and Chaaban (2013:4) declared that employees who are fit and normally perform physical activities have high chances of increased protection against the reproductive system and breast cancer. It was further noted that employees who do heavy manual labour jobs have even greater risk reduction than those who do light office work duties, who spend most of their time seated and not being physically active. According to Joyner and Coyle (2008), physical activity also plays a vital role in the management, control and treatment of Type II diabetes, where it assists in helping patients to keep their body fat levels in a healthy range and to help the body regulate blood sugar to an acceptable level. Joyner et al. (2008) further mentioned that diabetes is a group of disease which comes into being when there is a high prevalence of sugar in the bloodstream. This basically occurs when the body does not make enough use of insulin, effectively leading to a host of health problems such as damage to the eyes, kidneys, nerves, heart and blood vessels. It is recorded that diabetes is regarded amongst the leading causes of death in South Africa. Joyner et al. (2008) stated, therefore, that people who engage in physical activities are less likely to suffer from Type II diabetes than sedentary people, in that it helps to reduce body fats, decrease insulin resistance, increase insulin sensitivity and the body’s ability to clear sugar from the blood in an appropriate time. 28 According to (2015:12) increased physical activities can assist individuals who are dealing with the challenge of obesity with weight control, reduce the risk of disease, strengthen muscles, improve mental health, and increase the possibility of living longer. Biswas et al. (2015:12) suggested the following steps that should be taken by individuals to improve their physical wellness at the workplace:  Engage in regular walks within the premises, which include fitness breaks of 3-5 minutes every hour each day.  Use of stairs instead of elevators unless an employee is physically not feeling well or is disabled.  Develop a habit of standing up a few times a day to loosen the muscles.  Instead of sending emails, rather walk to the next workstation when there are issues to discuss.  Participate in sports and recreational activities that are employer-sponsored. In support of the arguments above, Zhang and Chaaban (2013:6) contended that participating in physical activities helps maintain excellent physical and mental health. Employers should continuously encourage their staff members, more specifically office-bound employees, to participate in sports and activities and to integrate these as part of their daily routine physical activities. 2.4.4 Emotional wellness Adams et al. (1997) declared that emotional wellness is regarded and defined as a level of awareness of an individual’s feelings and how such an individual gains control of such feelings. It also involves the manner in which an individual can cope with stress and further maintain a fulfilling relationship with others. Emotional wellness could also be considered to include various factors, which, amongst others, include management of feelings, self-awareness, and the way in which an individual can manage relations. Ryan and Deci (2011:34) pointed out that the self- determination theory is one other aspect that fits within the concept of self-realisation as the key aspect of health and wellness. 29 It should be noted that emotional wellness develops as and when an individual reaches certain levels of maturity, which enables one to gain a sense of purpose in life. Emotional wellness is also viewed from a perspective where an individual gains a sense of self-awareness about personal feelings, actions, relationships, and autonomy Ryff and Singer (2006) affirmed that emotional wellness enables an individual to cope with stress and to maintain a positive attitude towards life while being optimistic about the future. It should be noted that the prevalence of negative emotions in an individual affects the way in which one will feel and behave, thereby contributing to the low level of concentration and productivity at the workplace. Van der Merwe (2011) declared that if negative emotions, including stressors, are not coped with, an individual may resort to psychological substitutes such as anger, withdrawal, negativism, self-blame, committing incidents and errors while performing his/her job and other issues which could be risky to such an employee or others. For employers, it is, therefore, vital always to take cognisance of the symptoms that are aligned with emotional and behavioural challenges that employees could be facing. Most importantly, employers should capacitate and train managers and supervisors to be alert or aware of such and to know the process of assisting such employees to deal with their emotional challenges. Nel, Jonker and Rabie (2013:11) outlined the symptoms of stress and emotional problems to include high blood pressure, hot flushes, headaches, gastrointestinal disorders, increased glucose and cholesterol levels, sleep disorder, elements of substance abuse, absenteeism, changes in moods, changes in eating habits, aggression, and other behavioural and, to a certain extent, medical problems. These are some of the issues that managers and supervisors will have to be trained to identify if an employee is experiencing a lack of emotional wellness. It should also be noted that some of the psychological challenges that result in a lack of emotional wellness are factors that are workplace-related. These factors include lack of interpersonal relations, dissatisfaction with work, harassment, bullying, and negative treatment, and an unconducive working environment, which employees find themselves subjected to. As a result, employees who are subjected to negativity have a high probability of being stressed, which, in turn, could lead to negative behaviours such as absenteeism, presenteeism, substance abuse, excessive intake 30 of caffeine and other stimulants. Nel et al. (2013:11) suggested in pursuit of improving the emotional wellness of employees at the workplace that it is crucial for employers to establish and implement various health and wellness programmes in the workplace. Such programmes should be able to assist employees to deal with issues which have the potential of affecting the well-being, such as counselling and trauma support, training in interpersonal relations, management and supervisory training on people management. Nel et al. (2013:12) further stated that each workplace should create a supportive and consultative culture that seeks to acknowledge the value of employee well-being across all dimensions of wellness. Employers should also create an environment that considers and recognises emotional well-being issues of employees that are part of the success of the organisation in achieving its performance targets. In line with the above argument, it is vital for the Department of Labour to ensure that work activities are satisfying and that there are constant promotion and consideration of employee emotional well-being. The Department should consider various interventions which will improve the emotional wellness of employees, which includes stress management training, regular trauma debriefing to targeted employees at risk of exposure, accessibility to counselling services to all employees in need, including their immediate family members. Robertson and Cooper (2011) suggested the following strategies that employers should consider to improve the emotional wellness of employees:  Make available information that promotes emotional and mental health through the use of various forms of media;  Encourage employees to take part in employer-initiated sports and recreational activities, and also in local community sports activities as a way of relieving stress;  Make available accessible counselling services through the use of various technologies such as telephone counselling, social media, and personal face to face;  Conduct regular contact sessions with staff members to deal with and empower employees on various issues about emotional, mental and 31 behavioural problems such as stress management, depression, developing resilience, conflict resolution and so forth;  Encourage social cohesion in the workplace as a tool to foster positive spirit, creating healthy rapport, social and support networks and team building amongst employees;  Implement programmes to address elements of bullying, harassment, and other issues which could affect organisational wellness; and  Periodically conduct an employee satisfaction survey and act upon their recommendations to improve the working conditions and employee morale. 2.4.5 Spiritual wellness Petchsawanga and Duchon (2012:194) maintained that spiritual wellness recognised that employees invest in their daily work activities a combination of physical and spiritual aspects. Such a recognition implies that it is only when individual employees work with the spiritual commitment that they find a sense of meaning in the jobs they are doing, which ultimately leads to and results in self-efficacy. It is worth noting that spirituality does not only assist in addressing incidents of stress conflict, presenteeism and absence from work, it also assists with enhancing job performance, productivity, and employee well-being in the workplace. Schoeman (2017:1) defined spiritual wellness as a combination of various aspects that is all about obtaining a connection to something with a sense of value and meaning which ultimately transcends ordinary life. Furthermore, the author pointed out that the spiritual dimension of wellness involves seeking and finding the purpose and meaning of life. Also, it includes the enhancement of an in-depth recognition of the life and natural forces that exist in the universe. Adams et al. (1997) defined spiritual wellness as a process of seeking meaning and purpose of existence. Based on the definitions, spiritual wellness could be understood as involving the process of appreciating the greater purpose of our existence as individuals and understanding the reason why we are doing what we do. It involves seeking to understand the true meaning and purpose of life while focusing on finding a harmonious point with others. 32 Bester and Muller (2012:5) stated that the main features of spiritual wellness have their basis in the creation of personal values and belief systems where each individual grows towards life’s purpose and is dependent on the relationship with others. The argument is based on the notion that spirituality is located within an environment where the real meaning and purpose of life are explored. As an individual begins to develop the spiritual dimension, one will find peaceful harmony between internal personal feelings and emotions. It should be recognised that spirituality is paramount in the enhancement of emotional wellness, while also ushering in healthy interpersonal relations in the workplace. Bester and Muller (2017:5) declared that spiritual wellness makes provision for a blueprint towards which organisational values are transcended through the workflow processes, while at the same time facilitating a sense of connectedness with fellow employees in a manner that promotes a feeling of completeness. The view by Bester and Muller (2017) clearly indicates that spiritual wellness is an important element that seeks to influence the culture of the organisation in as far as how the employees will execute their roles or perform their functions in the workplace. Roof (2015) further noted that spiritual wellness could be understood from three perspectives namely the individual, organisational, and interactive levels. At an individual level, spiritual wellness can be viewed in how an individual brings his/her own spiritual ideas to the workplace, and at an organisational level it can be viewed in how the organisation supports the individual spiritual ideas, but also how the individual perceives the organisation, and at an interactive level it involves the way in which an individual and the organisation relate to as far as their values are concerned. To summarise, it could, therefore, be argued that spiritual wellness is about an individual finding a purpose in life, creating a connection with both the fellow employees or colleagues and the organisation, with the bottom line being to strike a balance between personal or individual value to the organisational values. Roof (2015) argued that for a long time, the benefits of spiritual wellness and physical wellness had been well documented. He argued that at most, at a rudimentary level, there is some kind of spiritual activity that makes one live longer. In support of the argument by Bester et al. (2017), Mishra, Togneri, Tripathi and Trikamji (2017) declared, in a study examining the association between mortality and spiritual 33 activities, that individuals with higher spiritual and religious involvement are likely to die older than their counterparts. This notion is supported by the fact that various religious and spiritual practices forbid certain practices and intake of certain substances that are known to be contributory factors towards either communicable or non-communicable diseases. For instance, Christianity cautions against taking too much alcohol or smoking, which has serious health effects. Bester et al. (2017:10) argued that the lack of spiritual wellness could exacerbate the prevalence of psychological disorders such as depression, anxiety, and post- traumatic stress disorder. Some of the disorders are commonly experienced in the workplace and results in the employees not able to function effectively, thus affecting the organisation. Mishra et al. (2017) have studied the relationship between spiritual wellness and psychological disorders, where they found that the symptoms that are usually related to the psychological disorders can have an influence at emotional, intellectual, psychical, and or social levels and could be because of a lack of spiritual wellness. Daniel and Chatelain-Jardon (2015:41) suggested that to promote spiritual wellness; management of an organisation is key in ensuring the creation and implementation of policies that seek to promote and integrate spirituality in the workplace. This view is supported by Marques (2005), who proposed various organisational activities to promote spiritual wellness in the workplace that includes:  Assisting employees to be in touch with nature by making available natural features at the workplace;  Conducting meetings outside the premises of the employer, preferably in an outdoor environment;  Making space and time available for employees to take exercise, meditation and relaxation breaks to promote physical and spiritual wellness;  Observe, on an annual basis, special organisational days, which are adopted as a culture of the organisation to acknowledge certain milestones and achievements;  Contribute towards creativity and encourage open expression of cultural and spiritual belief systems; and  Conduct team building and cohesion sessions to allow employees to get to know each other better. 34 Schoeman (2017) proposed that another possible way to establish spiritual wellness in the workplace is through the mission statement of the company, where the institution or organisation can create a mission statement that reflects positive values, that is friendly and based on values in which individuals can feel pride, and ensure that mission statements could function as guides to direct behaviours and decisions of employees. Thus, the organisations have the responsibility to ensure that all employees adopt, breathe, and make the mission a daily life experience (Schoeman, 2017). Bester and Muller (2017) stated that organisations could use several ways of disseminating the mission statement to their employees. They mentioned that annual reports, posters, plaques, employee manuals, newsletters, meetings, and training sessions could be used for this purpose (Bester & Muller, 2017). The other possible ways to create or improve workplace spirituality can be performed by giving more freedom to employees in personalising their cubicles, painting walls in bright colours, displaying spiritual messages, and providing 30 minutes of meditation. Jurkiewicz and Giacalone (2004) indicate that where spiritual wellness is recognised, such an organisation tends to have a prevalence of high values such as integrity, justice, mutual responsibility and trust. Promoting a sense of spirituality in the workplace not only benefits an organisation but also promotes employees’ well- being. Furthermore, the authors indicate that workplace spirituality tends to lower employees’ frustration at work. Also, if employees experience a friendly, supportive, and respectful environment in their workplace, they are more likely to reciprocate by behaving in the same manner as their colleagues. This will create a cooperative and warm working atmosphere, which is a factor that can lower stress and promote the psychological well-being of employees. 2.4.6 Psychological Wellness Mlangeni (2017:19) intimated that psychological wellness is the cornerstone of mental health and it is, therefore, an essential element of the six dimensions of wellness. Wright (2010:144) alleged that psychological wellness is responsible for the feeling that an individual would experience a highly positive atmosphere and endure relatively few negative emotions. In essence, psychological wellness 35 provides the ability of an individual to be able to take control and charge of their own emotions and feelings to function effectively beside any painful or negative emotional experiences. Chatervendula and Joseph (2007:17) also defined psychological wellness as an individual’s evaluation and judgement of their life regarding either satisfaction (cognitive evaluation) or affect (emotional reactions). That is further divided into pleasant affect (positive feelings) and unpleasant affect (negative feelings). One can, therefore, deduce that psychological wellness is concerned with the manner in which individuals manage their feelings and emotions to function effectively in the workplace. Foxcroft and Roodt (2013) described self-acceptance as the ability to know one’s self where one can strive to perceive one’s actions, motivations and feelings accurately and to accept all aspects of oneself which include good and bad qualities that one possesses. Self-acceptance can only be achieved through an honest self- introspection of strong and weak points that leads to the development of a self- awareness component of emotional intelligence. Kin (2014) declared that self- acceptance is crucial for an employee’s health, particularly mental health since its absence could result in some emotional difficulties that could render an employee incapacitated to effectively perform their duties. It is, therefore, important that employees should accept who they are, regarding their strength, and challenges, as that will enable them to source solutions to handle their weaknesses. Foxcroft and Roodt (2013) advanced the idea that positive relationships fall within the interpersonal scope that is constituted by an individual having strong feelings of empathy for all others, about their capacity to develop relationships, and the affection that they have for other human beings and the way in which they relate to others. It is vital that the aspect of a positive relationship is developed in the workplace, that will ensure that there is a prevalence of good interpersonal relations amongst managers, supervisors, and employees. In that way, employees can discuss challenges that affect their functioning, not only at the operational level but also at a personal level, thus promoting employee well-being. Mlangeni (2017) claimed that the way in which employees relate positively to each other in the workplace leads to close and collegial relationships, which are based on elements of trust and affection, and as such it creates an environment of trust where employees can work in peace 36 and where there is the promotion of greater goal attainment, committed employees, improved job performance, and reduction of employee turn-over rate. Foxcroft and Roodt (2013) asserted that autonomy refers to an individual’s ability to function independently with or without constant supervision. When employees have a certain level of autonomy, they are practically motivated to perform their functions without constant supervision or to be told what to do. It also enables them to apply the skills set which they possess to improve their job performance to achieve the set goals. Nkewu (2014) declared that autonomy at work has the potential to enhance the self-esteem of employees, in that they believe that their supervisors have trust in their potential to deliver on expectations. Foxcroft and Roodt (2013) pointed out that when an individual finds purpose in life, it helps in the creation of meaning, sense of direction and intention, and it is also responsible for the individual’s development through various life stages. Development of purpose further motivates individuals to make resources available to guide them towards a certain direction as it provides the foundation that allows someone to be more resilient to obstacles, strains and stress. The development of a purpose in life allows employees to understand the main reason why they are at work, and what drives them to deliver on the mandate of the Department. It will enable them to fully dedicate their time to serve the public or clients of the Department. In support of such initiative by employees, it is vital that the employer should provide an environment that enables employees to cope with various obstacles and strains that could affect their job performance. Foxcroft and Roodt (2013) postulated that personal development and growth is concerned with the realisation of personal ability to perform as per expectation and at times beyond that. Mlangeni (2017) said that when individuals feel that they are developing continuously, they experience a sense of achieving their potential, where personal growth leads to a fully functional person in the family, work relationships and other relationships in society. An environment that is supportive of employees that include personal training, skills training, mentoring, and coaching, can influence personal growth and development at work. Employers should put effort into ensuring that employees are provided with an opportunity to attend both formal and informal training programmes to enable them to grow in their role in the workplace. 37 2.5 ORGANISATIONAL WELLNESS PROGRAMMES Parks and Steelman (2008:34) suggested that wellness programmes in various organisations have an explicit aim of assisting organisations to improve service delivery or their productivity levels, which is accomplished through ensuring that employees are healthy and that their level of well-being enables them to perform their functions as expected. Parks et al. (2008) further professed that the main reason why organisations implement wellness programmes is to ensure that there is an improvement of the health and well-being of employees, and there is a reduction of organisational costs associated with absenteeism, incapacity, and presenteeism. Besides these facts, organisations seldom make efforts to assess the utilisation rate and uptake of the programme by employees, which translate on the effectiveness of the programme in meeting the set programme goals (Parks et al. 2008:34). Employee Wellness Programmes in South Africa operate within a specific economic and organisational context. Specific legislative imperatives have been put in place to provide guidelines on the Employee Wellness Programme (EWP). The government has also outlined its key strategic priorities and the creation of decent work. The public sector as an employer equally strives to contribute towards the ILO Decent Work Agenda that aims to entrench sustainable development as a pillar centred on workers. In 2009, the DPSA introduced the framework that strives to regulate the implementation of the wellness programmes in Public Service Departments. The policy framework provides clear guidelines on implementation of the wellness management programme, which is the subject of the current study. The framework further has clear intentions of strengthening and improving the efficiency of service delivery and also introduces more interventions to improve the well-being of employees. As indicated above, employee wellness is governed by certain key legislative and policy imperatives that inform its implementation. The White Paper on Human Resources of 2000 stipulates a commitment to a total wellness programme. 38 Steinman (2009) also regarded Employee Wellness as a programme that is also guided by the following legislation: The Constitution of the Republic of South Africa No 108 of 1996, which forms a foundation and basis towards the legal framework for the employee wellness management; Occupational Health and Safety Act, No 85 of 1993; Compensation for Occupational Diseases and Injuries Act (COIDA) No 130 of 1993; Employment Equity Act No. 55 of 1998; Basic Conditions of Employment Act No. 75 of 1997, Labour Relations Act No. 66 of 1995, and the National Policy for Health Act No 116 of 1990. 2.5.1 Structure and building blocks of a wellness programme The DPSA (2009:16) stated that the overall Employee Health and Wellness programme has its foundation in the various legislative frameworks and consists of the following three critical components: • The vision and mission of the strategy including the manner in which they are managed, communicated and institutionalised; • The four functional pillars for achieving the vision and mission of the strategy; and • The core principles for implementing the strategy, which serves as a set of guidelines to organise and manage interventions for employee health and wellness in the workplace. As per figure 2.2 below, the DPSA 2009 indicates that the framework consists of the following functional pillars, being • Pillar 1: HIV & AIDS, STI and TB Management; • Pillar 2: Health and Productivity Management; • Pillar 3: Safety, Hygiene, Environment, Risk and Quality Management; and • Pillar 4: Wellness Management. The current study focuses only on the wellness management pillar. The implementation of the wellness management programme is supported by a set of policy directives, key interventions and monitoring and evaluation instruments. Figure 2.2 below presents the functional pillars of the Employee Health and Wellness Programmes: 39 Figure 2.2: Conceptual framework for EHW in the public service, (DPSA, 2009:16) 2.5.2 Wellness management programme in the public service Ololade (2009:12) defines wellness as a state of complete human functioning, which involves the body, mind and spirit and also includes a variety of other key activities geared towards improving and increasing the level of awareness, risk assessment and psycho-educational interventions to promote behaviour change aimed at improving the well-being of both the individual and a group, thus contributing to the modification of health behaviour and enhancement of personal well-being and productivity. The DPSA (2009:31) pointed out that wellness as a programme developed and was given priority because of an increased recognition that safety, health and well-being of employees directly influence the productivity of the entire organisation. The framework further confirms that wellness as a programme is viewed as a state of health and well-being of individuals and groups within an organisation, with two main focal points being the achievement of the individual’s full 40 potential at the physical, social, spiritual and economic levels, and also the achievement of an individual’s role expectations in the family, community and the workplace. The Wellness Management pillar that is the fourth pillar of the framework has its foundation in Employee Assistance and the Work-Life Balance Programmes. The EAP was traditionally geared towards supporting mainly individuals through counselling and provision of psycho-educational interventions, without consideration of other health-related matters that could be contributory factors to psychosocial problems experienced by employees. Pillay and Terblanche (2012:34) declared that the consideration of the work-life balance programme that institutions are implementing is a vital programme, as they enable employers to accommodate employees’ personal lives and family needs and promote the requisite level of flexibility, and that results in higher levels of employee satisfaction and motivation. Pillay et al. (2012:34) postulated that wellness management clearly intends to meet the well-being needs of employees in an organisation that is achieved through implementation of various interventions that could either be proactive or reactive. Based on the argument above, it could be understood that the sole purpose of a wellness management programme is to ensure that employees’ well-being is promoted and protected. Reardon (1998:117) is of the opinion that wellness is the combination of all aspects or dimensions such as physical, social, emotional, spiritual, psychological as a means to achieve employee well-being. He further argued that wellness goes beyond the idea that health is an absence of illness, but that it should be viewed as a proactive stance towards achieving optimal physical, mental and emotional well-being of an employee (Reardon, 1998). 2.5.3 Sub-Pillars of Wellness Management Programme The DPSA (2009) outlines four sub-pillars of the Wellness Management Pillar, which could be divided into two categories: individual and organisational wellness. The DPSA (2009:31) defined individual wellness as the promotion of the physical, social, emotional, occupational, spiritual, and intellectual wellness of individuals. 41 Furthermore, the DPSA claimed that the promotion and attainment of individual wellness are obtained by ensuring an organisational climate and culture that is receptive, and conducive to wellness and the identification of related psychosocial risks. On the other hand, organisational wellness seeks to promote a culture that is conducive to both individual and organisational wellness and includes work-life balance geared towards the enhancement of the effectiveness and efficiency of the public service at large. Anticipated end-results of the wellness programme are to ensure that systems are in place to support employees fully and optimally engage their potential for a better and improved service delivery. This can only be achieved through creating a conducive environment that promotes well-being. The DPSA (2009:32) outlined the following four key competencies of Wellness Management Programme as illustrated in figure 2.3 below: Figure 2.3: Wellness Management Pillar, DPSA, 2009:32 42 The elements of figure 2.3 will be outlined in detail below, where each sub-pillar will be unpacked in detail. 2.5.3.1 Individual Wellness (Physical) Seward (2001) maintained that physical wellness is the optimal functioning of all the body’s physiological systems to help maintain (healthy) homeostasis that includes having appropriate body composition, flexibility, muscular strength, cardiorespiratory endurance, and practising health behaviours that include the following:  Physical activity and fitness by warming up the body before exercise and cooling the body down after exercise, exercising regularly, and maintaining muscle flexibility and a range of motion in body joints, participating in recreational sports and/or activities that help maintain fitness; and  Nutritional balance by eating a variety of foods, the recommended amount of servings in the food groups, maintaining desirable body weight, limiting saturated fats and cholesterol in the diet, and drinking plenty of water. DPSA (2009:55) described physical wellness as the ability to sustain the quality of life that permits an individual to go through daily activities with less or no fatigue or stress. The framework further proposed that the central objective of physical wellness is to promote the individual physical wellness of employees to advance fitness and a healthy lifestyle. The promotion of healthy lifestyles is central to ensuring employee personal well-being and improved productivity at an organisational level. In achieving the objective of the physical wellness programme, the strategy requires that departments implement the following:  Establishment of fitness, recreational facilities, encourage personal exercise and implementation of programmes that show a high utilisation rate.  Proactive programmes such as awareness and psycho-educational programmes to engage, capacitate and empower employees on aspects of nutrition, weight control, medical surveillance, lifestyle and disease management. 43  Establish an information system with the sole purpose of raising awareness through electronic and print information sharing. 2.5.3.2 Individual Wellness (Psychological) Van Wyk (2015) described psychosocial wellness as factors that relate to the interaction between the person and their social environment, and the influences on the person’s behaviour. Steinmann (2008:54) asserted that psychosocial wellness focuses on preventing and providing solutions towards psychosocial problems, such as stress, physical and emotional violence, work overload, and substance abuse, using risk assessments and policies, as well as organisational, environmental, and individually focused interventions. The DPSA (2009:56) recommended that the central objective of the psychological wellness is to promote the management of individual psychosocial wellness. In achieving that, departments are required to ensure that programmes aimed at enhancing and managing various wellness programmes at a psychological level such as financial, emotional, counselling and trauma debriefing, stress management, grief counselling, and other forms of interventions are available to promote social, financial, emotional and spiritual wellness. 2.5.3.3 Organisational Wellness Parks et al. (2008:1) described organisational wellness as a combination of internal and/or external services that are offered by the employer to employees with the aim of promoting health and well-being, while at the same time addressing health- and wellness-related problems. Furthermore, the other driving force for organisations to implement wellness programmes is to reduce costs associated with unhealthy practices and also to improve employee morale, thereby boosting productivity levels Parks et al. (2008). The DPSA (2009:56) contended that organisational wellness is responsible for the creation and promotion of a culture that is conducive to employees for performing their functions, thus contributing towards enhanced effectiveness and efficacy in service delivery. This is supported by the objective of organisational wellness that is to promote the organisational and institutional culture that is conducive to both the individual and organisational wellness to enhance the 44 effectiveness and efficiency of the public service. In achieving that, the DPSA (2009) requires that departments must ensure that:  Psycho-educational and awareness programmes and policies are in place;  Absenteeism and presenteeism are managed and monitored;  Interventions and programmes aimed at addressing issues about psychosomatic illness, stress, trauma, harassment, workplace bullying and violence, being factors that affect organisational wellness, are implemented. 2.5.3.4 Work-Life Balance The DPSA (2009:57) advanced the idea that a work-life balance programme promotes elements of flexibility in the workplace and recognises the relationship between work, personal and family needs, which could be beneficial to the organisation, as it promotes job satisfaction and improves employee morale and motivation. It should be understood as the basis of the definition that the main intention of work-life balance is to assist employees to manage all aspects of their lives fairly, which includes work, family and personal life. Therefore, to achieve work- life balance, it is important that the department should:  Develop and implement policies that support the flexibility of employees in line with the Basic Conditions of Employment Act;  Develop a culture of recognition of good and outstanding performance in the form of performance awards and rewards;  Create a conducive work environment where employees will be able to address their challenges without fear of being victimised or prejudiced; and  Make available and accessible a bouquet of wellness services to enable the employee to deal with personal challenges affecting performance and productivity. 2.6 EMPLOYEES AWARENESS AND ATTITUDES TOWARDS EWPS Bright et al. (2012:78) believed that it is vital and critical to first comprehend the attitude of employees regarding wellness. Such an understanding will help in ensuring that the programme which is developed meets the expectations of 45 employees since it will be based on their needs and aspirations rather than what employers think they should provide. Sieberhagen et al. (2009:4) suggested that organisations implement wellness programmes to reducing costs and to increase productivity, which then leads to more emphasis being placed on making a profit as a key output and the well-being of employees being treated as a by-the-way, unfortunately, more often than not, employees get to be aware of such intentions and then they tend to develop a negative attitude towards the programme. Lassen et al. (2007) postulated that key to developing a positive attitude amongst employees towards the programme is prevalent of trust, confidentiality and ethical values in an organisation, that are critical issues that employees consider when it comes to participating in wellness programmes. However, if employees feel or perceive that there is a lack of such aspects, they will not participate whole-heartedly, but if they do engage, they will do so just for the sake of it and hence might not derive full benefit from it. Employers should, therefore, take note that what would encourage employees to participate in the programme is when the programme adheres to principles of confidentiality, implemented in an atmosphere of trust, and ethical considerations. Employee attitude and perception have a way of influencing how effective and efficient the wellness programme becomes. This is supported by Sangweni (2006) who argued that where programmes are communicated and understood by employees, there seem to be higher levels of utilisation of such programmes. Moreover, it also results in improved productivity and achievement of organisational goals. What builds a positive attitude towards a wellness programme is the combination of trust, confidentiality and adherence to ethical considerations by the organisation. Such aspects are very critical and are considered in depth by employees when they opt to participate in wellness programmes. However, if the employees feel that the service provided does not conform to the expected standards, they will either not participate or not participate whole-heartedly. Dawad (2014:21) reasoned that most employees do not participate in the programme as a result of lack of requisite knowledge and awareness about the programme. He further claimed that a lack of knowledge and awareness contributes even more towards the negative attitude that employees could have towards the programme (Dawad, 2014). Therefore, it simply implies that employee attitude towards wellness 46 improves once they have been exposed to the programme. Therefore, it is essential for each organisation to understand that increasing participation of employees in the programme, is extremely necessary and important to market and raise awareness about the programme. Lassen et al. (2007) contended that employers could ensure that employees are aware of the various wellness programmes on offer through the use of various means of raising awareness such as regular communication, use of social media to promote the programmes, supervisory referrals and also as part of new employee induction. 2.7 EMPLOYEES’ PARTICIPATION IN WELLNESS PROGRAMMES According to Edwards (2012:39), employee participation is regarded as an important factor in the success or failure of employee wellness programmes, and it is therefore vital for managers to maximise employee participation in wellness activities and programmes. Furthermore, to achieve adequate employee participation, the programme must be sufficiently comprehensive to have a direct impact on the health and well-being of employees (Edwards, 2012). Kolacz (2015:30) reasoned that a workplace wellness programme is normally voluntary, and as such, there is no prescriptive legislation that requires employees to participate. Therefore, employers are then presented with a huge challenge of encouraging employees to participate and do not have the powers to discipline those who fail to take part in the programme. This, therefore, presents a situation where the participation rate will differ from one organisation to the other, and also one intervention to the other, within an organisation. There are various factors that impact on participation and utilisation of wellness programmes, and also factors that could be used to improve participation and utilisation, as demonstrated in figure 2.2. It is then followed by a detailed discussion. 47 INDIVIDUAL FACTORS  Demographic indicators  Perceived health status  Perceived stress Categories of factors SOCIAL FACTORS contributing to employee  Support by colleagues participation to wellness  Supervisor support programmes ORGANISATIONAL FACTORS  Organisational climate  Job flexibility BARRIERS TO EMPLOYEE PARTICIPATION  Health knowledge  Self-efficacy  Family commitment  Trust in supervisor  Programme scheduling Figure 2.4: Factors contributing and barriers to employee participation (Edwards, 2012) Kolacz (2015) indicated that there is several factors that are at the individual, social and organisational level, which affect or contribute towards employee participation in a wellness programme. Such factors are highlighted or presented in figure 2.2 above and are individual, social and organisational factors. Individual factors include demographic indicators, perceived health status and perceived stress. Regarding demographic indicators, Kolacz (2015) intimated that the participation of males and females in wellness programmes varies, where females happen to participate more in health screenings and exercise activities, as compared to males. Furthermore, Shepard (2000) highlighted that limited or lack of physical fitness and ability and increased vulnerability to communicable diseases and chronic stress make it difficult for older employees to participate in some physical activities, while more vigorous activities such as contact sport are attractive to young employees. This demographic information clarifies what induces employee participation, particularly regarding health screenings and physical activities. 48 Regarding perceived health status, Henry (2015) stressed that when employees have a high level of perceived or real knowledge of their health status, they are more likely to be attracted to participate in wellness programmes, as opposed to those with limited or less perception about their health status. It is also important to realise that, at times, employees participate in health and wellness programmes because of the need to know to make an informed decision about their life and their future, such as taking life covers or insurance. Henry (2015) supported the argument that an employee who participates in wellness programmes are mostly those who derive optimal benefit and they are likely to be the healthier and most productive in an organisation. The arguments by the authors presented above clearly indicate that health employees view wellness programmes as effective ways to support and maintain their behaviour and lifestyles. Regarding perceived stress, Abraham, Feldman, Nyman and Barleen (2011) claimed that excessive workload, responsibilities, workplace violence, bullying and job complexity, are part of the issues that have been identified to contribute to workplace stress. Kolacz (2015) suggested that employee perceived stress can, therefore, influence an employee’s willingness to participate in wellness programmes, where influences of stress on participation operate in the opposite direction, which results in employees with high perceived stress either being more motivated to participate or not participate. The social factors that influence employees’ participation in a wellness programme are support by colleagues and supervisors. Kolacz (2015:35) maintained that wellness programmes conducted at the workplace tend to be effective because of various influencing factors such as peer encouragement, management referrals and leadership by example. The organisations are, therefore, regarded as a suitable and relevant environment for the implementation of wellness programmes when support by colleagues is encouraged. Support by colleagues is much more related to an informal referral system that is used for counselling services. Duncan and Mummery (2005) suggested that social support is a vital influence that is necessary to influence participation in wellness programmes. 49 Furthermore, Duncan et al. (2005) maintained that social support could be associated with informal competitiveness amongst colleagues that increases commitment and thus is acknowledged as having a positive effect on participation. Goerzel and Pronk (2010) suggested that the management style applicable in the workplace goes a long way towards determining and influencing employee participation in wellness programmes. Edwards (2012) pointed out that where there are management buy-in and leadership by example, employees tend to participate in wellness programmes. Therefore, it is vital that management should understand the value of wellness programmes in the workplace to influence programme uptake by employees. Management buy-in and leading by example is of vital importance in this regard. Kolacz (2015:35) believed that managers should act as change agents and should, therefore, adopt a more positive approach to wellness interventions, which will act as an encouraging force for the creation of a workplace wellness culture that seeks to support employee participation. The organisational factors influencing participation are organisational climate and job flexibility. Bagwell and Bush (2000) defined organisational climate as a set of internal characteristics that differentiate one organisation from the other. Therefore, the climate that exists in an organisation is fundamental to determine the level of participation by employees. Kolacz (2015:35) pointed out that the perception of employees towards the social and interpersonal aspects of their work happens to affect their perception of the organisational climate that, in extension, affects their participation. It is also important to recognise that an organisation with a healthy climate is ideal to encourage participation, in that employees will view such an environment to be supportive of their health and well-being. Kolacz (2015:35) maintained that job flexibility is normally characterised by non-standard working hours, varied workspaces, and a flat organisational hierarchy, which invites workers’ autonomy and decision-making responsibilities. A study by MacEachen, Polzer and Clarke (2008) showed that employees with higher job flexibility are more able to improve their well-being through their participation in wellness programmes. Job flexibility allows and enables employees to participate freely in wellness programmes, without restrictions that come because of work overload that at times results in stress and sedentary health challenges. 50 However, there are some barriers to participation, such as commitment and lack of time, lack of self-efficacy, inconvenient scheduling, and lack of trust. Edwards (2012:58) maintained that barriers affecting employee participation in wellness activities do not support the good intention of the programme in the workplace, and it is important for management to have a greater awareness of such factors if they are to improve its implementation and employee participation. Abraham et al. (2011) said that when employees are highly pressured and carrying more than the expected responsibilities at work and family commitment they are less likely to participate in a wellness programme. Family and work commitment referred to here could be related to aspects such as caring for children, elderly parents, household chores, demanding work projects that are time-bound and unsupportive work climate. In support of the argument advanced, Abraham et al. (2011) found that most female employees without children are more likely to utilise employer initiated wellness programmes, as compared to women with children. In a study by Edwards (2012), it was found that employees who generally smoke, are aware of the negative impact and risks associated with their behaviour. However, they will choose not to participate in a programme aimed at assisting them to stop smoking. Furthermore, it is important to note that previous experience linked with bad habits have a greater influence in shaping a person’s decision to participate or not. In essence, it implies that previous experience in wellness programmes and activities has the greater potential of reducing an individual’s beliefs in their prospects of success, thereby creating a barrier to participation. Edwards (2012) alleged that if employees do not trust that their wellness information will be kept confidential either by the programme staff or by managers, they will most likely not participate. Therefore, to prevent a situation where employees perceive wellness initiatives as being intrusive and jeopardising their privacy, it is crucial that the principle of confidentiality be upheld to enable employees to gain and develop trust in the programme. Edwards (2012) postulated that if activities are scheduled at times when employees are at their peak regarding service delivery, it hampers their optimal participation. It is therefore vitally important that wellness activities should be scheduled during times when the workplace is least busy with core activities. Goerzel and Pronk (2010) further suggested, in pursuit of increasing employee 51 participation, it is vital for employers to schedule wellness activities during working hours, which is a clear demonstration that an organisation is committed to improving the well-being of employees. To ensure that scheduling does not become a barrier, managers should grant the opportunity for employees to participate in the programme. The challenge is: what can be done to improve employee participation in wellness programmes? It is fundamentally essential for any employer to ensure that employees participate in various wellness programmes on offer. Hence, employers would use various device strategies to improve employee participation. Chenoweth (2013:3) suggested the use of incentives being one of the several strategies which management can use to improve employee participation in wellness programmes. At times, participation in health and wellness interventions requires the use of incentives by employers to encourage their employees to participate and to lead healthy lifestyles (Justice, 2013). Many organisations are faced with a challenge of poor participation of employees in a wellness programme that at the end renders the programmes little impact as a “nice to have”. Therefore, it is vital that the department, in line with the argument by Chenoweth (2013:4) use some type of incentives to encourage employees to participate in the programme. For the incentive scheme to be successful, such incentives should target the primary behaviour that influences wellness. Various literature in the field of wellness management suggests that building incentives as part of the programme help raise participation levels amongst employees. Baicker, Cutler and Song (2010:14) suggested that wellness programmes may be the best way to counter the rising cost of insurance by improving employee wellness, and reducing the demand for medical services. Baicker et al. (2013:22) suggested that monetary and achievement rewards, public recognition and time-off can be used to good effect to improve employee participation. 52 2.8 EMPLOYEES SATISFACTION WITH EWPs Bhatti and Qureshi (2007) maintained that satisfaction refers to the rate at which one’s needs and wants have been met or fulfilled. They added that employee satisfaction is then the measure of how employees are satisfied with various elements of their work life and environment, which implies that there is a variety of issues that could affect employee satisfaction in an organisation. In the context of this study, employee satisfaction with a wellness programme could also be based on some factors, which the study aims to unpack. Sageer, Rafat and Agarwal (2012) pointed out that employees who are more loyal and productive in an organisation are those whose needs are satisfied, and in turn, they affect customer satisfaction and organisational productivity. It should also be noted that there are no limitations for the employees to achieve satisfaction, and satisfaction differs from one employee to the other. At times, satisfaction could be related to the current perception and experience that employees have towards the programme. Jorgensen, Villadsen, Punnett and Holtermann (2016) posited that for employees to achieve a level of satisfaction, at times, they need to adjust and change their behaviour for them to get the value of services that are offered to them. They further mentioned that there are various factors that contribute to employees' satisfaction that relates to positive and good relations with colleagues, training and development opportunities, career progressions, a safe and healthy working environment and other forms of benefits that the employer provides (Jorgenson et al., 2016). Robroek et al. (2009) regarded employee satisfaction as terminology that is used to describe if employees’ needs and desires are satisfied or fulfilled in an organisation. Accordingly, what contributes to employee satisfaction becomes a factor in motivating employees to achieve organisational goals to instil positivity, and boost employee morale. In essence, employee satisfaction is the combination of the effective reaction to the various perceptions of what an employee expects to receive as compared to what the employee did receive. 53 Batorsky, Taylor, Huang, Liu and Mattke (2016) proposed that satisfaction with wellness programmes is derived from the fact that the employer can provide wellness services that meet the expectations of employees. In a study conducted by Batorsky et al. (2016) the majority of the respondents were 61% dissatisfied with employee wellness programmes, where they do not believe that the employer has clear and good intentions of meeting the needs, which on its own is a contributor to low participation in the programme. It is important to note that where employees believe that wellness programmes improve their health and well-being, they are more likely to be satisfied, hence one will also realise the increase in uptake and participation. Various employers have developed a strong business case, which seeks to improve the overall health and well-being of their employees as a result of the realisation that employees whose health and well-being is compromised, happen to miss twice as many days from work as compared to those who are healthy (Robroek et al., 2009). Batorsky et al. (2016) postulated that most employers prioritise providing medical benefits to employees rather than providing effective wellness programmes; hence employee satisfaction levels would be affected. This is because of the view and attitude that employees develop which seem to suggest that employers are only interested in improving productivity and profit margins. Batorsky et al. further maintained that not only is there a gap between employers’ and employees’ perceptions of the effectiveness of the programme, but there is also disagreement on how employers should encourage their employees to make positive lifestyle changes to improve their health and well-being. Employee satisfaction with a wellness programme is also guided by the desire of employers to listen to their employees when formulating strategies that are aimed to promote their needs by improving their health and well-being. Also, when employers consider their employees’ strategies, they happen to achieve success at redesigning programmes and introducing new ones. The research by Batorsky et al. (2016) showed that there is considerable opportunity for employers to improve their health and well-being programmes based on feedback they received regarding the level of employees’ satisfaction. Batorsky et al. (2016) further maintained that the majority of employers, therefore, seek to improve wellness programmes. Hence they invest heavily to ensure that they succeed, with improved uptake and utilisation. 54 2.9 SUMMARY Wellness programmes are considered essential for any organisation, owing to the value these programmes add in respect of increasing employee performance, while at the same time improving productivity. Therefore, it is vital that the organisation should invest in wellness programmes, but at the same time, they should also ensure participation and utilisation of such programmes. As outlined in the literature, top management buy-in and support are essential for the success of the programme. It is also essential for inculcating the culture of wellness in the organisation that will see employees leading healthy lifestyles and to avoid unwell and risky behavioural patterns. It is vital to recognise that the success of a wellness programme is dependent on a number of factors that include, but are not limited to, assessment of participation, utilisation, employee perception about wellness, providing a platform that will create a positive attitude by employees towards the programme, and also the efforts by management to raise awareness about the programme. It is essential to determine the factors that contribute towards the utilisation and participation in wellness programmes by employees. Chapter Three will focus on the research method and design used in this study. 55 CHAPTER 3: RESEARCH METHODOLOGY 3.1 INTRODUCTION This chapter presents the research methodology and design used in conducting the study. The chapter will focus on key elements of research methodology, being research design, data collection, data analysis, research population, sampling procedure and research ethics. 3.2 RESEARCH METHODOLOGY Bryman et al. (2015:30) explained that research methodology is a strategy of enquiry, which moves from the underlying assumptions to research design and data collection. The study in question used quantitative research methodology since the objectives of this research focus on the design to produce statistically reliable data that tells us how many people are aware of the wellness programme, and the satisfaction and participation in the wellness programme. The study also intended to measure their perceived wellness behaviour levels and attitude towards the wellness management programmes. Bryman et al. (2015:31) pointed out that quantitative research methods are described as a specific research strategy that includes the collection of numerical data, and takes cognisance of the relationship between theory and research as deductive. It prefers a natural science approach in general and further adopts an objectivist conception of social reality. 3.3 RESEARCH DESIGN Welman et al. (2006:78) stated that there are various forms of research design which are classified into experimental, quasi-experimental and qualitative research. The study used a non-experimental design that Welman et al. (2006:92) declared as mainly used in exploratory and descriptive studies, where respondents are selected to take part in the research, and the relevant variables are measured at a specific time. As part of the non-experimental design, the researcher selected a choice of cross-sectional survey design which will deal with the various dimensions of the study. According to Bryman et al. (2015:105), the study is associated primarily with 55 56 social surveys, but also includes many other forms of research methods such as structured observation, content analysis, official statistics and diaries. Babbie (2007:102) postulated that a cross-sectional design is mainly used in exploratory and descriptive studies. Bless et al. (2006:47) were of the opinion that the main objective is to obtain an in-depth knowledge of a situation, phenomenon, community or an individual. An exploratory study was used to assess the degree to which employees are aware of the wellness programme and the rate at which they participate in the programme. It was also used to explore strategies to be implemented to improve the participation, awareness, satisfaction and factors to improve on perceived wellness behaviour levels. Descriptive research was used to unpack and describe the current level of employee participation, satisfaction, awareness and the perceived behaviour level. The researcher used the quantitative method as a blueprint for data collection and analysis, where statistical data was collected and analysed with the aim of answering research questions. Data was collected through a closed-ended administered questionnaire. 3.4 POPULATION AND SAMPLING PROCEDURE Welman, Kruger and Mitchell (2007:52) maintained that the study population is the set of objects that includes individuals, groups, organisations, events, or conditions to which they are exposed. The Department of Labour: Head Office employs around 797 employees, who are categorised according to the following categories: gender, age, race, and occupational level. The researcher used non-probability sampling, where purposive sampling will be considered. Bryman et al. (2015:186) stated that the aim of purposive sampling is to select participants of the study who will be relevant and satisfy the purpose of the study in as far as responding to the research questions framed regarding a questionnaire or an interview schedule. Welman et al. (2007:69) stated that researchers depend to a great extent on their experiences, intuition, and/or previous research experience to deliberately obtain a unit of analysis in a way that the sample 56 57 they obtain will be considered as being a good representative of the relevant population. Based on the arguments of Bryman (2015) and Welman et al. (2007), the researcher considered purposive sampling, where the sample obtained was regarded as being sufficiently representative to provide information about the study. Consideration was also given to the reality that the unit of analysis was, relatively speaking, not large. Therefore in pursuit of eliminating errors, the researcher considered 60% of the unit of analysis as a sample size, which amounted to a sample size of 478. The study obtained a response rate of 59.83% of the total sample size that equates to 286 of 478 employees. The units of analysis or study subjects are located at the departmental Head Office in Pretoria. The respondents were all supposed to participate and utilise the wellness management programme as offered by the Department. The respondents were appropriate and played a significant role in providing insight to the primary research question that sought to assess how employees’ awareness, attitudes, and satisfaction with the wellness management programme affect their participation and engagement in the program. 3.5 DATA COLLECTION According to Bless, Higson-Smith and Kagee (2007:111) data consists of measures collected as a result of scientific observation. Also, when researchers collect their own data for a particular study, it is called primary data, whereas when they use data collected by other investigators, it constitutes secondary data. For the current study, primary data that was quantitative was collected through a self-administered questionnaire. 3.6 MEASURING INSTRUMENT Bless, et al. (2007:117) explained that the respondents themselves, without the assistance of an interviewer, should complete self-administered questionnaires. The researcher used a structured questionnaire (attached as Annexure A), focusing on the following sections: 57 58 Section A: This section contained the biographical information of the respondents focusing on gender, age, years of service in the Department, branch attached to, and race of the respondents, occupational level, and educational level. Section B: In this section, the employees’ attitudes towards the wellness management programme was measured. The questionnaire used was developed by Walters (2014)) and consisted of ten items. A six-point Likert scale was used to measure the respondents’ perceived attitudes towards the wellness management programme, that ranges from strongly agree (1) to strongly disagree (6). Section C: This section measured employees’ awareness of the wellness management programme and consisted of three parts. Question C.1 aimed to establish if employees are aware of the wellness management programme offered by the Department. Respondents had to indicate yes (1) or no (2). Question C.2 aimed to establish how employees heard about the wellness management programme. The questionnaire consisted of six items. Question C.3 was designed to determine which wellness management programmes employees are aware of, or familiar with, and consisted of 17 items. Respondents had to indicate ‘no’ (1) or ‘yes’ (2). Section D: This section measured the employee participation levels in the wellness management programme and consisted of three parts. Question D.1 measured the employee's participation levels in specific wellness management programmes in the past twelve months. Respondents had to answer ‘no’ (1) or ‘yes’ (2) on 18 items. D.2 aimed to establish what factors would increase employees’ participation in the Department's wellness management programme. Respondents were requested to provide a ‘no’ (1) or ‘yes’ (2) answer to the nine questions. Section E: The last section measured the employees’ satisfaction levels with the wellness management programme. The section consists of six items. A five-point point Linkert scale, ranging from dissatisfied (1) to satisfied (5) was used. 58 59 3.7 VALIDITY AND RELIABILITY OF THE MEASURING INSTRUMENT According to Babbie (2004:143), in De Vos (2005:160), validity refers to the degree to which empirical measurement accurately reflects the concepts it is intended to measure. Validity has two aspects, being the concepts that the instrument seeks to measure and the accuracy of the measurement of the concepts. The researcher made use of the questionnaire instrument to gather information from the respondents. Validity was established based on judgment, that is, the researcher’s judgment about whether the measurement covers the universe of facets that make up the concepts. Ary, Jacobs, Sorensen and Walker (2014) declared that the Cronbach alpha (α) coefficient is the test which is commonly and frequently utilised to establish elements of internal consistency for data collected in the form of questionnaires. They further maintained that most researchers use the test when measuring instruments that contain items which are not scored truly as right or incorrect, as the object rating might be on a range of values on a Linkert mind-set scale. Ary et al. (2014) further explained that the aim of the Cronbach's alpha is the measurement of the reliability of a rating, while at the same time making a summary of test answers which measure some underlying factors. For each score computed, an acceptable average or cut-off point of 0.7 should be achieved to qualify that as being tolerable. It is, therefore, important to calculate and report Cronbach's alpha internal consistency reliability for any scales or subscales which one may be using. Table 3.1: Cronbach’s Alpha Coefficients Dimension Cronbach’s N of Mean Standard Internal Alpha (α) Items Deviation consistency Employees attitudes towards the 0.777 10 3.59 0.49 Acceptable wellness management programme (Section B) Employees satisfaction with 0.825 5 4.15 0.22 Good wellness management programme (Section E) Total 0.820 15 3.78 0.49 Good 59 60 The Cronbach’s alpha (α) coefficients in Table 3.1 above are closer to 1, and this implies that the participants have responded consistently to the survey items. Reliability analysis was not performed in sections C (awareness) and D (participation) because the responses were in a yes or no format (binary/dichotomous data). 3.8 ADMINISTRATION OF QUESTIONNAIRE The researcher distributed questionnaires to various categories of the employees as per study population. Permission to collect data was sought and granted by the Head of Department of Labour (approval attached as Annexure B). Questionnaires were circulated to staff members, who were given between one to two weeks to complete. The researcher collected all completed questionnaires. Since not enough questionnaires were collected, the researcher redistributed more questionnaires to improve the response rate, where ultimately 286 (59.83%) out of 478 questionnaires were collected. Data was then captured on Excel for analysis. 3.9 PILOTING AND PRE-TESTING Bryman et al. (2015:209) postulated that it is always desirable, if possible, to conduct a pilot study before administering a self-completion questionnaire or structured interviews schedule to your sample. Bryman et al. (2015:209) further maintained that piloting and pre-testing assist the researcher to clarify and correct questions that seem not to be understood or questions that are often not answered. The researcher is also assisted to consider how well the questions flow and whether it is necessary to move some of the questions around to improve the sequencing. In conducting piloting and pre-testing, the researcher sought the assistance of employee health and wellness practitioners based at Head Office, the Unemployment Insurance Fund, Compensation Fund and Wellness Champions. The use of the employee health and wellness practitioners and wellness champions was to avoid biases, which is supported by Bryman et al. (2015:209), who stipulated that 60 61 pilot and pre-testing should not be carried out on people who might have been members of the sample that would be employed in the actual full study. 3.10 PROCEDURES FOR QUANTITATIVE DATA ANALYSIS Bless et al. (2006:163) considered that once data collection and checking have been completed, the researcher should begin the process of analysing data. The analysis is conducted so that the researcher can detect consistent patterns within the data, such as the consistent co-variance of two or more variables. The following statistical methods were used: 3.10.1 Descriptive statistics According to Larson-Hall and Plonsky (2015), descriptive statistics form the basis for quantitative reasoning and is vital for any information obtained in a quantitative format in that they explain the record or data set, providing a factor of the estimate of the average range of the information, as well as estimates of variability in statistics. In addition, Brink et al. (2012) postulated that descriptive statistics are used to describe and summarise data and distinguish when data sets look identical. For this study, descriptive statistics were used to describe study elements, being employees’ perceived wellness behaviour, attitudes, awareness, participation and satisfaction through descriptive statistics. The elements of the study mentioned above were also analysed, using the Likert scale-based questions, ranging from strongly agree and strongly disagree, while some required a yes or no type of answer. 3.10.2 Independent samples t-test According to Welman (2008:237) the t-test enables the researcher to determine whether two groups which are subjects of the study have equivalent or different mean scores. In the case of this study, the purpose of the t-test was to compare the average responses of two populations. A t-test was used to measure the differences in the employees' attitudes towards and satisfaction with the wellness programme between the gender and demographic variables. It was also used to measure differences in the mean scores of attitudes towards the wellness management programme between males and females. Finally, it was used to measure differences 61 62 in the mean scores of the satisfaction with the wellness management programme between males and females. 3.10.3 ANOVAS According to Welman et al. (2008:231), the analysis of variance seeks to measure any statistical significant difference between means and distribution samples. The purpose of the ANOVA test is to compare the average responses of more than two populations. Samples are selected randomly from these populations, and the variances of the population responses are assumed equal. For the study, ANOVAs were done to measure the differences in the mean scores of attitudes towards, and satisfaction with, the wellness management programme between the age categories, occupational level, and branches. It was also used to test a comparison of the perceptions of employees from different age categories about satisfaction with the wellness management programme. It was further used to compare the perceptions of employees from different age categories about attitudes towards the wellness management programme, and also to compare the perceptions of employees from different occupational levels about satisfaction with the wellness management programme. Finally, it was used to compare the perceptions of employees from different occupational levels about the attitudes towards the wellness management programme. 3.10.4 Pearson product moment correlation According to Welman et al. (2008:230), a Pearson product moment correlation is a statistical method used to measure the degree of association between two intervals or ratio variables. For this study, the purpose of the Pearson product moment correlation was used to determine the relationship between employees’ attitudes and satisfaction with the wellness management programme. 3.11 RESEARCH ETHICS The primary objective of ethics in a scientific study is to ensure that the researcher adheres to the ethical consideration when conducting and completing the study. It is also to ensure that the researcher adheres to elements of confidentiality. Strydom 62 63 (2005b:57) defined ethics as a set of moral principles that offers behavioural expectations regarding the conduct towards respondents. The definition dictates that the study had to be guided by ethical principles when undertaking research, particularly towards the subjects of the study or respondents. Neuman (2000:481) also stated that ethics articulate a common set of values upon which professional and scientific work is based. In ensuring compliance with the generally accepted principles of ethical considerations, the researcher has to ensure that informed consent is obtained, where respondents or participants were provided with necessary information to enable them to make an informed decision on their participation. The respondents were also assured of their confidentiality and privacy where their personal information would not be required as part of data collection. The researcher further assured participants that the information to be obtained would be solely used for academic purposes towards completion of the MBA programme and that findings will be made available to the NWU Graduate School and the management of the Department. Permission to collect primary data using a questionnaire was obtained from the Head of the Department of Labour (Permission letter attached as Annexure B). The researcher was also granted ethical clearance (Ethical Number: NWU- 00469-17- A9) by the Institutional Research Ethics Regulatory Committee (Attached as Appendix C). 3.12 SUMMARY The chapter discussed in detail the research methodology used which consisted of research design, population and sampling procedure, data collection, data analysis, and ethical consideration. The chapter to follow will present an analysis of data collected using the questionnaire to produce meaningful information. 63 64 CHAPTER 4: DATA ANALYSIS AND INTERPRETATION 4.1 INTRODUCTION The Chapter seeks to present data as collected through the form of a self- administered questionnaire to employees of the Department of Labour, Head office - Pretoria. The questionnaire is presented and analysed in order of the research objectives and research questions as presented in chapter 1 of the study. The main objective of the study was to assess employee attitudes, awareness, participation and satisfaction regarding the wellness management programme of the National Department of Labour. Based on this object, the following research questions were formulated:  What are the employees' attitudes towards, awareness of, participation levels in and satisfaction with the wellness programme?  Are there differences in the employees' attitudes towards, awareness of, participation levels in and satisfaction with the wellness programme between the demographic variables?  What is the relationship between employees’ attitudes towards and satisfaction with the wellness programme?  What remedial intervention strategies can be suggested and implemented to improve the wellness management programme in the Department? 64 65 4.2 DESCRIPTIVE STATISTICS 4.2.1 Descriptive statistics of the demographic characteristics of respondents Figure 4.1: Gender Male 48% Female 52% From the data presented in figure 4.1 above, there is a slight margin between the two population groups being males (48%) and females (52%). The results indicate that the difference in frequency of the genders is insignificant as it is balanced between male and female. Figure 4.2: Age category 56yrs and above 1,40% 51 – 55yrs 4,20% 46 – 50yrs 10,50% 41 – 45yrs 18,20% 36 – 40yrs 28,70% 31 – 35yrs 18,50% 26 – 30yrs 13,60% 20 – 25yrs 4,90% 65 66 The data presented in figure 4.2, showed that the majority of the respondents are in the age group 36 to 40 years old, followed by those in the age groups 31-35 and 41- 45 years, accounting for 18.50% and 18.20% respectively. The study indicates that most employees utilising the programme are those who are older, as opposed to the young employees. The study further indicates that the Department should implement programmes which will be more enticing to the younger employees. Figure 4.3: Race White 9% Coloured 9% Indian 11% African 71% Regarding race, the majority of the respondents are Africans with 71%, as opposed to the other races with 11% and 9% respectively. The study indicates that Africans participate more in wellness programmes as opposed to other races. 66 67 Figure 4.4: Occupational Level 29,40% 30,10% 18,90% 14,70% 7% Senior Middle Junior Supervisors Admin and Management Management Management other staff categories Data presented in figure 4.4 indicates that the majority of the respondents are those who are at supervisory and junior management levels, accounting for 30.10% and 29.40% respectively, followed by those at middle management accounting for 18.9% and with those at administrative and other categories accounting for 14.7% and finally with members of senior management accounting for 7%. The results indicate that the programme awareness, participation and utilisation are highly concentrated at junior management and supervisory level staff. 67 68 Figure 4.5: Educational Level 46,90% 23,10% 20,60% 9,40% Grade 12 Diploma Degree Post Graduate Data presented in figure 4.5 above shows that the majority of the respondents have qualifications at a degree level accounting for 46.90% and those with diploma qualifications accounting for 23.10%, followed closely by those with post-graduate qualifications accounting for 20.60%. The results further provide evidence that the majority of the sampled population have qualifications and that is the key contributory factor towards employee knowledge, attitude and participation in the wellness management programme. Figure 4.6: Branch 27,60% 26,90% 23,10% 14% 8,40% Corporate Public Inspection and Labour Market Operations Services Employment Enforcement Policy Services Information 68 69 Data presented in figure 4.6 indicates that the majority of the respondents are based at Corporate Services accounting for 27.60%, followed by Inspections and Enforcement Services accounting for 26.90%, with Labour Market Policy Information accounting for 23.10%, the least being Public Employment Services and Operations branches accounting for 14% and 8% respectively. Representation at Corporate Services is higher, which could be because the programme is under Corporate Services. Figure 4.7: Number of work experience years in the Department Work experience (years) in the Department 37,10% 24,80% 17,80% 16,10% 4,20% 1 – 5yrs 6 – 10yrs 11 – 15yrs 16 – 20yrs 21yrs and above Data presented in figure 4.7 above indicates that the majority of the respondents (37.10%) have 11-15 years of work experience in the Department, while 24.80% have 6-10 years of work experience in the Department, followed by those with 16-20 years (17.80%). The results indicate that most employees have considerable experience in the Department, which in turn could be a contributory factor towards awareness, participation and attitude towards the wellness management programme. 69 70 4.2.2 Descriptive statistics regarding employees attitudes towards, awareness of, participation levels in and satisfaction with the wellness programme In line with data presented in table 4.1 below, a mean of 4.02 indicated that on average respondents agree and strongly agree that the employee wellness programme benefits them, and a mean of 4.22 indicate that on average employees agree and strongly agree that the employee wellness management programme staff are helpful. Furthermore, a mean of 4.03 shows that respondents believe that the Department of Labour employees benefit from the wellness management programme, a mean of 3.76 indicate that respondents believe that their participation in a wellness management programme should lower their monthly health insurance premium; a mean of 3.96 indicated that respondents believe that the Department has a responsibility to offer a worksite wellness management programme; furthermore, a mean of 3.43 believe that they are better able to maintain their health goals when co- workers have similar goals; and a mean of 3.32 indicated that respondents know someone at work who supports their healthy lifestyle improvements; also a mean of 3.31 indicated that respondents believe that their direct supervisors support their involvement in the wellness management programme; a mean of 3.24 believe that the Department encourages/promotes wellness at work and home; and a mean of 2.62 indicates that respondents believe that administration is supportive of the wellness management programme. Lastly, the overall mean of 3.59 showed that, on average, 286 respondents agree with the attitude statements. The individual standard deviations for the 10 items in the table deviate slightly from zero. It means that few respondents strongly and slightly agree with the attitude statements. Table 4.1: Employees’ attitudes towards the wellness management programmes Statements N Mean SD The wellness management programme directly benefits 286 4.02 1.02 me The wellness management programme staff are helpful 286 4.22 .82 The Department of Labour’s employees benefits from the 286 4.03 .95 wellness management programme 70 71 My participation in the wellness management programme 286 3.76 1.13 should lower my monthly health insurance premium I think the Department of labour has a responsibility to 286 3.96 1.04 offer worksite wellness management programme I am better able to maintain my health goals when co- 286 3.43 1.21 workers have similar goals I know someone at work who supports my healthy 286 3.32 1.23 lifestyle improvements My direct supervisor supports my involvement in the 286 3.31 1.28 wellness management programme The Department of Labour encourages/promotes 286 3.24 1.22 wellness at work and at home Administration is supportive of the Department of 286 2.62 1.32 Labour's wellness management programme OVERALL MEAN 3.59 Employees’ awareness of the wellness management programme is depicted in tables 4.2; 4.3 and 4.4. In response to the question, whether employees are aware of the wellness management programme, 81.1% have indicated ‘yes’ that shows that the majority of employees in the Department are aware of the wellness management programme. Table 4.2: Employees awareness of the wellness management programme Yes No (%) (%) Are you aware of the Wellness Management Programme offered by 81.1 18.9 the Department of Labour? In response to the question of how did they know or hear about the programme, data presented in table 4.3 indicates that the majority of the employees maintained that they became aware of the wellness management programme through new employee orientation which accounted for 32.8% and also through articles which are published on exchange postmaster, which accounted for 50.9% of the respondents. The results show that these two above-mentioned sources of creating awareness are fundamental in raising awareness about the wellness management programme. However, it also shows that more efforts should be made to improve on other systems, which recorded a low response rate, such as the use of iDoL, the EHW 71 72 Newsletter, EHW information sessions, and that supervisors and colleagues should play a more active role in creating awareness. Table 4.3: Information sources for creating awareness Items % New Employee Orientation 32.8 Articles on Exchange Postmaster 50.9 iDoL articles 5.6 EHW newsletter 4.3 EHW information sessions/Presentation 1.3 Supervisor or colleague 5.2 Total 100 The respondents were requested to indicate their awareness levels of the various wellness management programmes offered by the Department. The majority of the respondents indicated that they are aware of the wellness management programmes which are implemented in the Department, which includes a stress management programme with 87.1%; education and awareness programmes for nutrition, weight control, medical interventions, lifestyle and chronic diseases with 86.7%; preventive and curative programmes such as financial and spiritual well-being with 85.7%; psychosocial well-being programmes, including counselling with 85.3%; systems for the dissemination of wellness information through the electronic and print media with 84.6%; health screening programme with 84.6%; and management of alcohol and drugs through workplace alcohol and drug programmes with 82.9%. Table 4.4: Employees’ awareness levels of wellness management programmes Items No Yes Physical fitness, exercise and recreation programmes 32 .2 67 .8 Education and awareness programmes for nutrition, weight control, 1(%3.3) 86.7 medical interventions, lifestyle and chronic diseases Systems for the dissemination of wellness information through the 15.4 84.6 electronic and print media Preventive and curative programmes such as financial and spiritual 14.3 85.7 well-being Psychosocial well-being programmes including counselling 14.7 85.3 Organisational development programmes such as workplace 25.2 74.8 discrimination, victimisation, harassment, violence and workplace bullying Fair labour practices programmes or workshops 34.3 65.7 72 73 Programmes and workshops to promote flexible work policies and 28 72 practices and how to maintain a work-life balance Availability of childcare facilities 46.5 53.5 Availability of retirement programmes 36.4 63.6 Availability of programmes on gender, disability and youth in the 22.4 77.6 workplace Healthy sleep therapeutic programme 44.8 55.2 Smoking cessation programme 39.2 60.8 Health screening programme 15.4 84.6 Stress management programme 12.9 87.1 Management of alcohol and drugs through workplace alcohol and 17.1 82.9 drug programmes Change management programmes 40.2 59.8 AVERAGE PERCENTAGE (%) 26.6 73.4 Despite the fact that the majority of the respondents are aware of wellness management programmes offered by the Department, participation seems to be low, where the majority of the respondents indicated that they have not participated in the wellness management programmes: fair labour practices programmes and workshops accounting for 66.9%; utilisation of child care facilities accounting for 82.9%; programmes and workshops on the promotion of flexible work policies and practices and how to maintain a work-life balance accounting foro 63.6%; healthy sleep therapeutic programme accounting for 77.3%; smoking cessation programme accounting for 61.5%; retirement planning programme accounting for 65.7%; and organisational development programmes, such as workplace discrimination, victimisation, harassment, violence and workplace bullying accounting for 52.4%. The results further proved that only participation in wellness management programme is limited to a few programmes, which include: education and awareness programmes for nutrition, weight control, medical interventions, lifestyle and chronic diseases accounting for 70.6%; preventive and curative programmes such as financial and spiritual well-being accounting for 59.8%; psychosocial well-being programmes including counselling accounting for 51.7%; programmes on gender, disability and youth in the workplace accounting for 52.4%; health screening programme accounting to 65%; stress management programme accounting to 66.1%; management of alcohol and drugs through a workplace alcohol and drug 73 74 programme accounting for 54.2%; and programmes on physical fitness, exercise and recreation programmes accounting for 55.9%. The results indicated the need for the Department to improve on encouraging employees to participate in all programmes on offer, through the use of various strategies, as per table 4.6. Table 4.5: Employees participation levels in the wellness management programmes Items No Yes I have participated in physical fitness, exercise and recreation 44.1 55.9 programmes I have participated in education and awareness programmes for 29.4 70.6 nutrition, weight control, medical interventions, lifestyle and chronic diseases I have received wellness information through the electronic and print 33.6 66.4 media I have participated in preventive and curative programmes such as 40.2 59.8 financial and spiritual well-being I have made use of psychosocial well-being programmes including 48.3 51.7 counselling I have participated in organisational development programmes such as 52.4 47.6 workplace discrimination, victimisation, harassment, violence and workplace bullying I have attended fair labour practices programmes and workshops 66.8 33.2 I have attended programmes and workshops on the promotion of 63.6 36.4 flexible work policies and practices and how to maintain a work-life balance I have utilised the child care facilities 82.9 17.1 I have attended a retirement programme 65.7 34.3 I have participated in programmes on gender, disability and young 47.6 52.4 people in the workplace I have participated in a healthy sleep therapeutic programme 77.3 22.7 I have participated in a smoking cessation programme 61.5 38.5 I have participated in a health screening programme 35 65 I have participated in a stress management programme 33.9 66.1 I have attended the management of alcohol and drugs through a 45.8 54.2 workplace alcohol and drug programme. 74 75 Items No Yes I have attended a change management programme 59.1 40.9 AVERAGE PERCENTAGE (%) 52.2 47.8 In accordance with data presented in table 4.6 below, the majority of the respondents are advancing the following as measures which should be used to improve employee participation in the wellness management programme offered by the Department: creation of culture of wellness management, accounting for 92%, where employees will understand the purpose of participating; wellness management programmes should be offered free of charge, where employees will not be expected to make financial contributions towards the programme, accounting for 92.3%; the Department should make it convenient for employees to participate in wellness management programmes,, which should be during office hours accounting for 92.3%; employee privacy and confidentiality to be protected and respected accounting for 95.8%; supervisory support to enable employees to participate, accounting for 92%; management buy-in and leadership by example where managers should also take the lead in participation as it will create a supportive culture and commitment to wellness, accounting for 96.5; and that the Department should consider improving on communication of wellness management programmes and provision of incentives, accounting for 89.9% and 88.5% respectively. The strategies as outlined above could fundamentally assist in improving employee participation in all wellness management programmes. Table 4.6: Factors that will increase participation in the wellness management programmes Items No Yes Proper advertising and communication of wellness management 10.1 89.9 programmes Create a culture of wellness management 8 92 Wellness management programmes should be offered free of charge 7.7 92.3 Provide incentives 11.5 88.5 Making it convenient to participate in wellness management 7.7 92.3 programmes for example during office hours Respect employee privacy and guarantee confidentiality 4.2 95.8 Support from supervisor to attend 8 92 Leaders and managers should participate to create a supportive culture 3.5 96.5 75 76 and commitment to wellness AVERAGE PERCENTAGE (%) 7.6 92.4 In line with data presented in table 4.7, a mean of 4.22 shows that, on average, respondents are satisfied with the overall wellness management programme. A mean of 3.75 shows that the respondents are satisfied with the departmental wellness facilities. A mean of 4.26 shows that, on average, respondents are satisfied with the wellness management staff. A mean of 4.26 shows that respondents are satisfied with the wellness programmes and workshops that they have attended, and also a mean of 4.24 indicates that the respondents are satisfied with communication about wellness programmes events. The overall mean of 4.15 shows that, on average, 286 respondents are somewhat satisfied with the wellness programme. The individual standard deviations for the 5 items in the table deviate slightly from zero. It means that few respondents are entirely satisfied and the majority of them are somewhat satisfied with the wellness programme. Table 4.7: Employees satisfaction with the wellness management programmes Item N Mean Standard Deviation The overall wellness management programme 286 4.22 0.72 The Department of Labour’s wellness facilities (gym, 286 3.75 1.30 walking paths) Wellness management programme staff 286 4.26 0.80 Wellness Programmes and workshops that you have 286 4.26 0.77 attended Communication on events 286 4.24 0.76 OVERALL MEAN 4.15 4.3 DIFFERENCES IN THE EMPLOYEES' ATTITUDES TOWARDS AND SATISFACTION WITH THE WELLNESS PROGRAMME BETWEEN THE DEMOGRAPHIC VARIABLES An independent samples t-test was conducted to compare the attitude scores for males and females, and the results are shown in Table 4.8. There was a significant difference in scores for males (M = 3.71, SD = 0.63) and females (M = 3.48, SD = 0.66; t (284) = 3.008, p = 0.003, two-tailed). 76 77 Table 4.8: Independent samples t-test to measure differences in the mean scores of attitudes towards the wellness management programme between males and females Levene's Test for Equality of Variances t-test for Equality of Means 95% Confidence Interval of the Sig. Mean Std. Error Difference F Sig. t df (2-tailed) Difference Difference Lower Upper Attitudes Equal variances .060 .807 3.008 284 .003 .23 .08 .08 .38 assumed Equal variances 3.015 283.625 .003 .23 .08 .08 .38 not assumed An independent samples t-test was conducted to compare the mean satisfaction with the wellness management programme scores for males and females, and the results are shown in Table 4.9. There was a significant difference in scores for males (M = 4.23, SD = 0.56) and females (M = 4.06, SD = 0.78; t(284) = 2.096, p = 0.037, two- tailed). Table 4.9: Independent samples t-test to measure differences in the mean scores of the satisfaction with the wellness management programme between males and females Levene's Test for Equality of Variances t-test for Equality of Means 95% Sig. Confidence Interval of the (2- Mean Std. Error Difference F Sig. t df tailed) Difference Difference Lower Upper Satisfaction Equal 6.866 .009 2.096 284 .037 .17 .08 .01 .33 variances assumed Equal 2.125 267.639 .035 .17 .08 .01 .33 variances not assumed A one-way between-groups analysis of variance was conducted to explore the impact of age on the attitudes of employees towards the wellness management 77 78 programme. The results are presented in Table 4.10. The respondents were divided into five groups according to their age (Group 1: 30 yrs and below; Group 2: 31 – 35 yrs; Group 3: 36 – 40 yrs; Group 4: 41 – 45 yrs, Group 5: 46 yrs and above). There was no significant difference at the p > 0.05 level in attitudes scores for the five age groups: F(4, 281) = 2.071, p = 0.085. Table 4.10: ANOVA to compare the perceptions between different age groups about attitudes towards the wellness management programme Sum of Squares Df Mean Square F Sig. Between Groups 3.473 4 .868 2.071 .085 Within Groups 117.850 281 .419 Total 121.323 285 A one-way between-groups analysis of variance was conducted to explore the impact of occupational level on the attitudes of employees towards the wellness management programme. The results are presented in Table 4.11. The respondents were divided into five groups according to their occupational level (Group 1: senior management; Group 2: middle management; Group 3: junior management; Group 4: supervisors, Group 5: admin staff). There was no significant difference at the p > 0.05 level in attitudes scores for the five occupational levels: F(4, 281) = 1.137, p = 0.339. Table 4.11: ANOVA to compare the perceptions of employees between different occupational levels about the attitudes towards the wellness management programme Sum of Squares Df Mean Square F Sig. Between Groups 1.932 4 .483 1.137 .339 Within Groups 119.391 281 .425 Total 121.323 285 78 79 A one-way between-groups analysis of variance was conducted to explore the impact of branch on the attitudes of employees towards the wellness management programme. The results are presented in Table 4.12. The participants were divided into five groups according to their branch (Group 1: corporate services; Group 2: public services employment; Group 3: inspection and enforcement services; Group 4: labour market policy information, Group 5: operations). There was a significant difference at the p < 0.05 level in attitudes scores for the five branches: F(4, 281) = 4.353, p = 0.002. Post hoc comparisons using the Scheffe test indicated that the mean score for Group1 (M = 3.81, SD = 0.54) was significantly different from Group 3 (M = 3.42, SD = 0.65). Groups 2 (M = 3.49, SD = 0.76), 4 (M = 3.63, SD = 0.61) and 5 (M = 3.48, SD = 0.72) did not differ significantly from either Group 1 or Group 3. Table 4.12: ANOVA test to compare the perceptions of employees between different branches regarding the attitudes towards the wellness management programme Sum of Squares df Mean Square F Sig. Between Groups 7.080 4 1.770 4.353 .002 Within Groups 114.243 281 .407 Total 121.323 285 A one-way between-groups analysis of variance was conducted to explore the impact of age on the satisfaction of employees about the wellness management programme. The results are presented in Table 4.13. The participants were divided into five groups, according to their age (Group 1: 30 yrs and below; Group 2: 31 – 35 yrs; Group 3: 36 – 40 yrs; Group 4: 41 – 45 yrs, Group 5: 46 yrs and above). There was a significant difference at the p < 0.05 level in satisfaction scores for the five branches: F(4, 281) = 4.513, p = 0.002. Post hoc comparisons using the Scheffe test indicated that the mean score for Group 5 (M = 4.46, SD = 0.57) was significantly different from Groups 2 (M = 3.95, SD = 0.59) and 3 (M = 4.03, SD = 0.66). Groups 1 (M = 4.24, SD = 0.77) and 4 (M = 4.15, SD = 0.73) did not differ significantly from any of the groups 2, 3 and 5. 79 80 Table 4.13: ANOVA test to compare the perceptions of employees between different age groups about satisfaction with the wellness management programme Sum of Squares df Mean Square F Sig. Between Groups 8.095 4 2.024 4.513 .002 Within Groups 126.014 281 .448 Total 134.109 285 A one-way between-groups analysis of variance was conducted to explore the impact of occupational level on the satisfaction of employees with the wellness management programme. The results are presented in Table 4.14. The participants were divided into five groups, according to their occupational level (Group 1: senior management; Group 2: middle management; Group 3: junior management; Group 4: supervisors, Group 5: admin staff). There was a significant difference at the p < 0.05 level in satisfaction scores for the five occupational levels: F(4, 281) = 3.573, p = 0.007. Post hoc comparisons using the Scheffe test indicated that the mean score for Group 3 (M = 3.98, SD = 0.80) was significantly different from Group 4 (M = 4.30, SD = 0.63). Groups 1 (M = 4.44, SD = 0.44), 2 (M = 4.09, SD = 0.68) and 5 (M = 4.09, SD = 0.57) did not differ significantly from either group 3 or 4. Table 4.14: ANOVA to compare the perceptions of employees between different occupational levels about the satisfaction with the wellness management programme Sum of Squares df Mean Square F Sig. Between Groups 6.492 4 1.623 3.573 .007 Within Groups 127.617 281 .454 Total 134.109 285 A one-way between-groups analysis of variance was conducted to explore the impact of branch on the satisfaction of employees towards the wellness 80 81 management programme. The results are presented in Table 4.15. The participants were divided into five groups according to their branch (Group 1: corporate services; Group 2: public services employment; Group 3: inspection and enforcement services; Group 4: labour market policy information, Group 5: operations). There was a significant difference at the p < 0.05 level in satisfaction scores for the five branches: F(4, 281) = 4.379, p = 0.002. Post hoc comparisons using the Scheffe test indicated that the mean score for Group1 (M = 4.34, SD = 0.52) was significantly different from Group 3 (M = 3.91, SD = 0.78). Groups 2 (M = 4.13, SD = 0.92), 4 (M = 4.23, SD = 0.55) and 5 (M = 4.07, SD = 0.52) did not differ significantly from either group 1 or group 3 Table 4.15: ANOVA test to compare the perceptions of employees between different branches regarding satisfaction with the wellness management programme Sum of Squares df Mean Square F Sig. Between Groups 7.869 4 1.967 4.379 .002 Within Groups 126.240 281 .449 Total 134.109 285 4.4 RELATIONSHIP BETWEEN EMPLOYEES’ ATTITUDES TOWARDS AND SATISFACTION WITH THE WELLNESS MANAGEMENT PROGRAMME The Pearson product moment correlation was done to determine the relationship between employees’ attitudes towards and satisfaction with the wellness management programme. The correlation between satisfaction and attitude of employees towards the wellness management programme is significant (p-value = 0.000 < 0.05 level, two-tailed). The corresponding correlation coefficient (r = 0.389) is positive. 81 82 Table 4.16: Pearson product moment correlation to measure the relationship between attitudes towards and satisfaction with the wellness management programme Attitude Satisfaction Attitude Pearson Correlation 1 .389** Sig. (2-tailed) .000 N 286 286 Satisfaction Pearson Correlation .389** 1 Sig. (2-tailed) .000 N 286 286 **. Correlation is significant at the 0.01 level (2-tailed). 4.5 SUMMARY The chapter presented, analysed and interpreted data obtained through the use of a self-administered questionnaire, with target group being all levels of employment at the Head Office of the Department of Labour. Data were presented and analysed aligned to the research questions and objectives, as outlined in chapter 1 of the study. Chapter 5 will focus on the discussion of principal findings, advancing recommendations and conclusions of the study. 82 83 CHAPTER 5: DISCUSSION, RECCEOMENDATIONS AND CONCUSION 5.1 INTRODUCTION This chapter focuses on presenting discussions of the main findings, advancing recommendations and also concluding the study. The discussions will be based on the objectives of the study which are linked to the research questions. The study will further advance proposals for future areas of study related to the subject matter. 5.2 DISCUSSION OF FINDINGS 5.2.1 Discussion of employee attitude towards, awareness of, participation levels in, and satisfaction with the wellness programme The first research question was concerned with the employees’ attitude towards, awareness of, participation levels in and satisfaction with the wellness programme. The study suggested that employees have a positive attitude towards a wellness programme, which is indicated by an overall mean of 3.59 of the respondents who responded positively to the attitude statement. The finding is supported by the study conducted by Dawad (2014), which advanced the idea that employees’ attitudes and perceptions have an influence on the effectiveness of the workplace programmes, where, if employees perceive the programme to be good and beneficial to them, and if their attitudes are positive, then ultimately their usage and participation will increase. The study further suggested that employees are aware of the wellness management programme offered by the Department, which is supported by 81.1% of employees who responded positively to the awareness statement. The study also suggested that employees are aware of various sub-programmes and interventions offered by the Department, which includes education and awareness programmes for nutrition, weight control, medical intervention, lifestyle and chronic illness; preventive and curative programmes such as financial and spiritual well-being; health screening programmes; management of drug and alcohol programmes; stress management programmes; psychosocial well-being programmes, which include counselling; and 83 84 organisational development programmes such as workplace discrimination, victimisation, bullying, violence and harassment. The finding is supported by the study conducted by Dlamini (2015), which indicates that employee knowledge and awareness is the prerequisite for participation in employee health and wellness programmes. Baicker et al. (2013) agreed by stating that participation in an employee health and wellness programme is improved when employees are aware and knowledgeable of the benefits of utilising the programme. From the employees who responded positively to the awareness statement, the study further suggested that awareness levels towards the programme are largely through the use of new employee orientation programmes and also articles on exchange postmasters, whereas the use of other forms of media, such as articles on IDoL, EHW newsletter, Information Sessions and supervisor or colleague referrals are not the key contributors to employee awareness. As such, the study further suggested the need to improve on the other platforms. Linked to the higher awareness levels, the study suggested that there are employees whose participation is only limited to the following programmes: education and awareness programmes for nutrition, weight control, medical interventions, lifestyle and chronic diseases; preventive and curative programmes such as financial and spiritual well-being; psychosocial well-being programmes, including counselling; programmes on gender, disability and youth in the workplace; a health screening programme; stress management programme; management of alcohol and drugs through a workplace alcohol and drug programme; and programmes on physical fitness, exercise and recreation. The study further suggested that, besides the high level of awareness, there are employees who never participated in certain programmes, such as fair labour practices programmes and workshops; utilisation of child care facilities; programmes and workshops on the promotion of flexible work policies and practices and how to maintain a work-life balance; a healthy sleep therapeutic programme; smoking cessation programme; retirement planning programme; and organisational development programmes such as workplace discrimination, victimisation, harassment, violence and workplace bullying. The findings are supported by the study conducted by Bright et al. (2012) in which it was alleged that when employees know about their health status, they may not see a 84 85 need to participate in certain wellness programmes offered by the employer. Bright et al. (2012) further claimed that employees might not be able to participate in all programmes offered by the employer, owing to various factors, such as lack of supervisory support, limited time to attend to wellness programmes, and at times, lack of incentives to improve participation. Hence, in the current study, employees do participate in other programmes while they also equally do not participate in certain programmes. The results showed the need for the Department to improve on encouraging employees to participate in all programmes on offer, through the use of the following strategies as suggested by the study: proper advertising and communication of wellness programmes; creation of a culture of wellness in the organisation; offering wellness programmes for free; providing incentives to encourage employee participation; ensuring that the programme is offered during working hours; respect of employee confidentiality; and management support and buy-in. The finding is supported by a study conducted by Edwards (2012), which proved that there is a need for managers to maximise employee participation in activities that make up wellness programmes that include a range of complementary activities and environmental conditions, influencing and enabling employees to participate in the programme. The study further suggested that employees are satisfied with the wellness programme implemented in the Department of Labour, which is supported by an overall mean of 4.15 of the respondents who were satisfied with the wellness programme satisfaction statements. 5.2.2 Discussion on the difference in the employee’s attitude towards, awareness of, participation levels and satisfaction with wellness programme between demographic variables The second research question was concerned with the differences in the employees' attitudes towards, awareness of, participation levels in and satisfaction with the wellness programme between the demographic variables being gender, age, 85 86 occupational levels, and branch to which employees are attached. The study suggested the following as per information presented in table 5.1 below. Table 5.1: Differences in the employee’s attitude towards, awareness of, participation levels and satisfaction with wellness programme between demographic variables Test of Hypothesis T-test ANOVA Attitude There was a significant Attitude towards the wellness programme difference in mean did not significantly depend on the age attitude scores for male group of employees (p = 0.085 > 0.05 level) and female employees Attitude towards the wellness programme (p = 0.003 < 0.05 level) did not significantly depend on the occupational level of employees (p = 0.339 > 0.05 level) Attitude towards the wellness programme was significantly dependent on the branch of employees (p = 0.002 < 0.05 level) Satisfaction There was a significant Satisfaction with the wellness programme difference in mean was significantly dependent on the age satisfaction scores for group of employees (p = 0.002 < 0.05 level) male and female Satisfaction with the wellness programme employees (p = 0.037 < was significantly dependent on the 0.05) occupational level of employees (p = 0.007 < 0.05 level) Satisfaction with the wellness programme was significantly dependent on the branch of employees (p = 0.002 < 0.05 level) The findings across demographical variables are supported by the study conducted by Dawad (2014), which found that there is a significant relationship between gender, attitude and satisfaction with the wellness programme, where females are more likely to participate and be satisfied with wellness programmes, as opposed to males. This is according to Dawad (2014) as expected, as females usually happen to 86 87 be the first to seek assistance ranging from various wellness interventions, whereas historically, males are less likely to seek assistance. The finding that the employee attitude is not significantly dependent on age and occupational levels is supported by the finding of the study conducted by Dlamini (2015), which found that the attitude of employees towards the wellness programme is not entirely influenced by their age, occupational classification, or their educational levels. However, it is profoundly influenced by various activities such as management support, relevance of the programme to the target group and the perceived benefit from the programme. The finding of the study that a wellness programme is significantly dependent on age and occupational levels of employees is supported by the study conducted by Bright et al. (2012), which disclosed that the age of employees have a bearing on the extent to which employees are satisfied by the programme, where younger employees will be more satisfied with energy-intensive programmes such as physical activities and team building, whereas the older employees would be satisfied by more formal and structured programmes, such as educational and awareness interventions. Edwards (2012) pointed out that occupational classifications also have a significant influence on participation and satisfaction, where mostly senior management would not participate in programmes, which include all other levels of employees, but would instead prefer to participate in an exclusive executive wellness programme, that affects their satisfaction levels. 5.2.3 Discussion of the relationship between employees’ attitude and satisfaction with wellness programme The third research question was concerned with the relationship between employees’ attitudes towards and satisfaction with the wellness programme. The results suggested that there is a significant correlation between employees’ attitudes towards and satisfaction with the wellness programme (p = 0.00 < 0.05 level) and the corresponding Pearson correlation coefficient (r = 0.389) is positive. The finding is supported by the study conducted by Sangweni (2006), which pointed out that if employees have a negative attitude towards the programme, their satisfaction level 87 88 will be affected, in that they will view the programme as being of poor quality and as such it will affect their participation, whereas if they have a positive attitude, their satisfaction level will improve and their participation as well. 5.3 RECOMMENDATIONS In order to improve the employee attitudes, awareness, participation levels and satisfaction with the employee wellness programme implemented by the Department of Labour, the following recommendations are advanced, out of which an implementation plan should be developed to action them:  Development of a plan to enhance programme uptake by employees across all four branches of the Department being Corporate Services, Inspection and Enforcement Services, Public Employment Services; Labour Market Information Services; and Operations. The strategy could include ensuring that the Wellness Committee is representative of all branches and also that top, senior and middle management buy-in is sourced to ensure optimal uptake and participation by all employees.  The Department should develop a plan to ensure programme uptake across various age categories, which will see an improvement on age groups with limited participation, particularly the youth category, which scored low. The Department should also consider implementing more programnes and initiatives that will entice participation of the youth. In this regard, an Employee Wellness Interest Survey should be conducted to determine programmes of interest for the youth category, so that implementation is informed and employee initiated rather than employee or specialist initiated.  The Department should also develop a strategy to implement progammes that will be relevant and responsive to the needs of various occupational categories, particularly senior and middle management and also admin and other category staff. For senior and middle management, programmes such as executive wellness programmes could be important to address participation challenges at that level. 88 89  In order to improve participation across all the employee wellness programmes offered, the Department should be aligned with the departmental communication strategy, do proper advertising and communication of the programme which will see enhancement of various other forms of communication, which are currently being underutilised.  In pursuit of enhancing a positive wellness attitude, the Department should institutionalise the culture of wellness through mainstreaming wellness into the core programmes and also ensure that senior managers become wellness champions and, in addition, support its implementation in their respective sections or workstations. Furthermore, the Department should ensure that all packages of wellness programmes on offer are provided for free to all employees. The programme should also be implemented during working hours, where employees will not be required to utilise their leave days when particularly attending to counselling sessions and other interventions. Critical to the enhancement of employee attitude, participation and satisfaction are to uphold the principle of confidentiality. 5.4 DIRECTION FOR FUTURE RESEARCH The current study proved that there is a relationship between employee attitude, awareness, participation and satisfaction with the wellness programme. Data analysed indicated employees do not participate in certain wellness programmes which are implemented by the Department; therefore as such, it is recommended that a study on perceived wellness behaviour levels as predictors for employee participation could be conducted in order to determine the extent to which perceived wellness behaviour levels affect employee participation in wellness programmes. It is further proposed that a study focusing on the funding model of wellness programmes in the public service should be conducted. This is in response to the growing concern around the wellness programme being poorly resourced and funded, where many government departments are unable to implement various facets of the programme. What is more, it results in instances where employees’ interest in the programme are lost, thereby affecting their participation and uptake of 89 90 the programme. In addition, as a result of poor funding, departments are unable to recruit and retain the skilled professionals required to implement the programme. The study should be able to explore, benchmark and propose a model similar to the one used for the Human Resource Development, which requires government departments to set aside an equivalent of 1% of the remuneration of employees/or personnel budget for the purpose of training and development of employees. 5.5 CONCLUSION In conclusion, the study demonstrated that employees seem to have a positive attitude and awareness of the wellness programme. It further indicated that employees participate in most wellness programmes, and are also fairly satisfied with wellness programmes offered by the Department. It is clear that a wellness programme plays a vital role in improving employees’ morale, thereby increasing the organisational and individual performance and productivity levels. The study has made significant recommendations, which are vital to improving employee participation and uptake of the programme, as discussed under item 5.3. Central to the improvement of the wellness programme is the role which managers and supervisors should play in ensuring that their subordinates’ well-being is prioritised by providing them a fair chance and opportunities to participate in wellness programmes, by making the necessary referrals to employees in need of interventions and also playing a support role during the process. Moreover, it is important that although the study has outlined positive findings on numerous objectives, intensification is necessary to ensure that the programme remains relevant, and uptake and participation are increased. The study also managed to confirm through findings the assumption that employee knowledge and awareness of the programme has a way of influencing their participation and uptake of wellness programmes, where the indication is that as a result of employees’ awareness of wellness programmes, many programmes enjoy a positive and high level of participation. The study further proved through findings that employee attitude has a positive impact on participation and satisfaction with the wellness programme. 90 91 LIST OF REFERENCES Abraham, J.M., Feldman, R., Nyman, J.A. & Barleen, N. 2011. What factors influence participation in an exercise-focused, employer-based wellness program? Inquiry, 48(3): 221-241. Adams, T., Benzner, J. & Steinhardt, M. 1997. The conceptualisation and measurement of perceived wellness: integrating balance across and within dimensions. American Journal of Health Promotion, 11: 208-218. Adams, T., Bezner, J., Garner, L. & Woodruff, S. 1998. Construct validation of the perceived wellness survey. American Journal of Health Studies,14(4): 212-218. Ary, D., Jacobs, L.C., Sorensen, C.K. & Walker, D.A. 2014. Introduction to research in education. 9th ed. New York, NY: Wardsworth Cengage. Babbie, E.R. 2004. The practice of social research. (In De Vos, A.S., Strydom, H, Fouché, C.B. & Delport, CSL. Research at grass roots for the social sciences and human services professions. 3rd ed. RSA, Pretoria: Van Schaik. p. 357-366). Babbie, E.R. 2007. The practice of social research. Wadsworth: Cengage Learning. Bagwell, M.M. & Bush, H.A. 2000. Improving health promotion for blue-collar workers. Journal of Nursing Care Quality, 14(4): 65-71. Baicker, K., Cutler, D. & Song, Z. 2010. Workplace wellness programs can generate savings. Health affairs (Project Hope). 29(2): 304-311. Batorsky, B., Taylor, E., Huang, C., Liu, H. & Mattke, S. 2016. Understanding the relationship between incentive design and participation in US workplace wellness programmes. American Journal of Health Promotion, 30(3): 198-203. 91 92 Beck, A.J., Hirth, R.A., Jenkins, K.R., Sleeman, K.K. & Zhang, M.A. 2016. Factors associated with participation in a University worksite wellness program. American Journal of Preventative Medicine, 51(1): 1-11. Berry, L.L, Mirabito, A.M, Baun, W.B. 2010. What’s the hard return on Employee Wellness Programs. 88(12): 104-112. Bester, A. & Muller, J.C. 2017. Religion, an obstacle to workplace spirituality and employee wellness? Verbum et Ecclesia, 38(1): a1779. Bhatti, K. & Qureshi, T. 2007. Impact of employee participation on job satisfaction, employee commitment and employee productivity. International Review of Business Research Papers, 3(2): 54-68. Biswas, A., Oh, P.I., Faulkner, G.E., Bajaj, R.R., Silver, M.A., Mitchell, M.S. & Alter, D.A. 2015. Sedentary time and its association with risk for disease incidence, mortality, and hospitalization in adults: a systematic review and meta-analysis. Annals of Internal Medicine, 162(2): 123-132. Bless, C, Higson-Smith, C. & Kagee, A. 2007. Social research methods. an African Perspective. 4th ed. South Africa, Cape Town: Juta. Bright, D.R., Terrell, S.L., Rush, M.J., Kroustos, K.R., Stockert, A.L., Swanson, S.C. & DiPietro, N.A. 2012. Employee attitudes towards participation in a work site-based Health and Wellness Clinic. Journal of Pharmacy Practice, 25(5): 530-536. Bryman, A. & Bell, E. 2015. Business research methodology. New York: Oxford University Press. Case, A. & Paxson, C. 2006. Children’s health and social mobility. The Future of Children, 16(2): 151-173. 92 93 Chaturvedula, S. & Joseph, C. 2007. Dimensions of psychological well-being and personality in military aircrew: a preliminary study. Indian Journal of Aerospace Medicine, 51(2): 17-27. Chenoweth, D. 2013. Wellness strategies to improve employee health, performance and the bottom line. SHRM Foundation. https://www.shrm.org/foundation/ourwork/initiatives/resources-from-past- initiatives/Documents/Wellness%20Strategies%20to%20Improve%20Employee%20Health.pdf Accessed 12 June 2017. Cohen-Mansfield, J. & Peach, R. 2015. Interventions for alleviating loneliness among older persons: a critical review. American Journal of Health Promotion, 29(3): 109- 125. Daniel, J.L. & Chatelain-Jardon, R. 2015. The relationship between individual spirituality, organisational commitment and individual innovative behaviour. Management Research and Practice, 7(1): 5-13. Dawad, S. 2014. Employees’ awareness, attitudes and utilisation of the Direct Axis Employee Wellness Programme. Durban: UKZN (Mini-dissertation – MBA). Duncan, M. & Mummery, K. 2005. Psychosocial and environmental factors associated with physical activity among city dwellers in regional Queensland. Journal of Preventive Medicine, 40(4): 363-372. Durlak, J. 2000) Health promotion as a strategy in primary prevention. (In D. Cicchetti, Rappaport, J. Sandler, I. & Weissberg, R. eds. The promotion of wellness in children and adolescents. Washington, DC: Child Welfare League Association Press. p, 221–241). EAPA-SA. 2010. EAPA-SA Standards and Professional Guidelines for Employee Assistance Programs. Pretoria. 93 94 Edwards, J. 2012. Understanding the predictors of participation and the barriers to employee involvement in workplace health promotion programmes. New Zealand: Massey University of Albany. (Thesis- PhD). Foxcroft, C. & Roodt, G. 2013. Introduction to psychological assessments in the South African context. 4th ed. Cape Town: Oxford University Press. Gibbs, B.B., Hergenroeder, A.L., Katzmarzyk, P.T., Lee, I.M. & Jakicic, J.M. 2015. Definition, measurement, and health risk associated with sedentary behaviour. Medicine & Science in Sports &Exercise, 47(6): 1295-1300. Goetzel, R. & Pronk, N. 2010. Worksite health promotion. How much do we really know about what works? American Journal of Preventative Medicine, 38(2): 223- 225. Gonzalez, K., Fuentes, J. & Marquez, L.J. 2017. Physical inactivity, sedentary behaviour and chronic diseases. Korean journal for family medicine, 38(3): 111-115. Hawe, P. & Shiell, A. 2000. Social capital and health promotion: a review. Soc Science Med, 51(6): 871-85. Helliwell, J.F. 2005. Well-being, social capital and public policy: what’s new? National Bureau of Economic Research, 1050 Massachusetts Avenue, Cambridge, MA 02138. Henry, M. 2015. Factors motivating employee participation in employer-sponsored Health Awareness Programs. Walden University, USA. (Thesis- DBA). Jorgensen, M.B., Villadsen, E., Burr, H., Punnett, L. & Holtermann, A. 2016. Does employee participation in workplace health promotion depend on the working environment? A cross-sectional study of Danish workers. BJM open, 6(6): Joyner, M.J., & Coyle, E.F. 2008. Endurance exercise performance: the physiology of champions. The Journal of Physiology, 586(1): 35–44. 94 95 Jurkiewicz, C.L. & Giacalone, R.A. 2004. A values framework for measuring the impact of workplace spirituality on organisational performance. Journal of Business Ethics, 49(2): 129-142. Justice, G. 2013. Lies & myths about corporate wellness. Prairie Village, KS: Create Space Independent Publishing Platform. Kin, Y.P. 2014. From vulnerability to resilience: multiple routes to social and self- acceptance as buffers of norm-based rejection sensitivity. Hong Kong: University of Hong Kong. (Dissertation – PhD). Kirsten, T.G., van der Walt, H.J. & Viljoen, C.T. 2009. Health, well-being and wellness: an anthropological eco-system approach. Journal of Interdisciplinary Health Sciences, 14(1): 407. Klautzer, L., Mattke, S., & Greenberg, M.D. 2012. Can we pay people for being good: a review of current federal and state law on wellness program incentives. RAND Corporation, 49(3): 286-277. Kolacz, M.N. 2015. Factors influencing employee participation and non-participation in a rural hospital's employer-sponsored Wellness Program. Minnesota: Walden University. (Thesis – Doctor of Nursing Practice). Larson-Hall, J. & Plonsky, L. 2015. Reporting and interpreting quantitative research findings: what gets reported and recommendations for the field. Language Learning, 65:127-159. Lassen, A. Bruselius-Jensen, M. Sommer, M.H, Thorsen, A.V. & Trolle, E. 2007. Factors influencing participation rates and employees’ attitudes toward promoting healthy eating at blue-collar worksites. Health Education Research, 22(5): 727–736. 95 96 MacEachen, E., Polzer, J. & Clarke, J. 2008. “You are free to set your own hours”: governing worker productivity and health through flexibility and resilience. Social Science and Medicine, 66(5): 1019-1033. Makgato, M.D. 2016. An evaluation of the effectiveness of employee wellness management programme in the Department of Agriculture in Capricorn District of Limpopo Province. Polokwane: UL (Mini-dissertation- MBA). Marques, J, Dhiman, S. & King, R. 2005. Spirituality in the workplace: developing an integral model and a comprehensive definition. Journal of American Academy of Business, 7(1): 81-91. Miller, G. & Foster, L.T. 2010. Critical synthesis of wellness literature. Victoria, Canada: University of Victoria. Mishra, S.K., Togneri, E., Tripathi, B. & Trikamji, B. 2017. Spirituality and religiosity and its role in health and diseases. Journal of Religion and Health, 56: 1282–1301. Mlangeni, N.G. 2017. Psychosocial factors influencing psychological well-being of South African State Security forces: an exploratory study. Stellenbosch: University of Stellenbosch.(Thesis – M Com). Myers, J.E. & Sweeney, T.J. 2005. The indivisible self: an evidence-based model of wellness. Journal of Individual Psychology, 61(3): 269-279. Naz, A.S., Rehman, R. Katpar, S.J. & Hussain, M. 2014. Intellectual wellness awareness: a neglected area in the medical universities of Pakistan. Journal of the Pakistan Medical Association, 64(9): 993-997. Nel, J.A., Jonker, C.S. & Rabie, T. 2013. Emotional intelligence and wellness among employees working in the nursing environment. Journal of Psychology in Africa, 23(2): 195-203. 96 97 Nel, P.S., Van Dyk, P.S., Haasbroek, H.D., Schultz, H.B., Sono, T. & Werner, A. 2004. Human Resource Management. 6th ed. Cape Town: Oxford University Press. Neuman, W.L. 2000. Social research methods: qualitative and quantitative approaches. Boston: Allyn and Bacon. Nicolaas, C. 2007. Perceptions of employees regarding utilisation of the in-house employee assistance programme model in the North West Department of Education. Pretoria: University of Pretoria. (Mini-dissertation – MSoc Sc). Nkewu, Z. 2014. The impact of psychological well-being and perceived combat readiness on the willingness to deploy in the SANDF: an exploratory study. Stellenbosch: Stellenbosch University. (Thesis- M Com). Ohuruogu, B. 2016. The contribution of physical activity and fitness to optimal health and wellness. Journal of Education and Practice, 7(20): 123-128. Ololade, O. 2009. Healing the work place: Wellness Initiative Programmes for the City of Marietta: Kennesaw State University. Olubayo-Fatiregun, M.A., Ayodele, R.B. & Olorunisola, H.K. 2014. Health, fitness and physical activity: a key to enhancing wellness for all ages in building a vibrant nation. Asian Journal of humanities and social sciences, 21(1): 77-81. Olufemi, O.O. 2017. Social isolation in the elderly; physical activity on the rescue. Degenerative Intellectual & Developmental Disability, 1(1): 1-3. Parks, K.M. & Steelman, L.A. 2008. Organizational Wellness Programs: a meta- analysis. Journal of Occupational Health Psychology, 13 (1): 58–68. Petchsawanga, P. & Duchon, P. 2012. Workplace spirituality, meditation, and work performance. Journal of Management, Spirituality & Religion, 9(2): 189- 208. 97 98 Pillay, R. & Terblanche, L. 2012. Caring for South African Public Sector employees in the workplace: a study of employee assistance and HIV/AIDS. Journal for Human Ecology, 39(3): 229-239. Reardon, J. 1998. The history and impact of worksite wellness. Nursing Economics, 16(3): 117-121. Renger, R.F., Midyett, S.J., Mas, F.G., Erin, T.E., McDermott, H.M., Papenfuss, R.L., Eichling, P.S., Baker, D.H., Johnson, K.A. & Hewitt, M.J. 2000. Optimal living profile: an inventory to assess health and wellness. American Journal of Health Promotion, 24(6): 403-412. Robertson, I. & Cooper, C. 2011. Well-being, productivity and happiness at work. London: Palgrave MacMillan. Robins,L., Jansons, P., O’Brien, L. & Haines, T. 2017. Gym-based and home-based exercise with telephone support have similar outcomes when used as maintenance programme on adults with chronic health conditions: a random trial. Journal of Physiotherapy, 63: 154-160. Robroek, S.J.W., Van Lenthe, F.J., Van Empelen, P. & Burdorf, A. 2009. Determinants of participation in worksite health promotion programmes: a systematic review. The International Journal of Behavioural Nutrition and Physical Activity, 6(26): 1-12. Roof, R.A. 2015, The association of individual spirituality on employee engagement: the spirit at work. Journal of Business Ethics, 130(3): 585–599. Rothmann, S. & Ekkerd, J. 2007. The validation of the perceived wellness survey in the South African Police Service. S.A Journal of Industrial Psychology, 33(3): 35-42. 98 99 Ryan, R.M. & Deci, E.L. 2011. A self-determination theory perspective on social, institutional, cultural, and economic support for autonomy and their importance for well-being. (In Chirkov, V.I, Ryan, R.M, & Sheldon, K.M., eds. Human autonomy in cross-cultural context: perspectives on psychology of agency, freedom, and well- being. Dordrecht, Netherlands: Springer, p 45-64). Ryff, C.D. & Singer, B.H. 1998. The contours of positive human health. Psychology inquiry, 9: 1-28 Ryff, C.D. & Singer, B.H. 2006. Best news yet on the six-factor model of well-being. Social Science Research, 35: 1103-1119. Sageer, A. Rafat, S. & Agarwal, A. 2012. Identification of variables affecting employee satisfaction and their impact on the organization. Journal of Business and Management, 5(1): 32-39. Sangweni, S.S. 2006. Evaluation of Employee Assistance Programmes in the public sector. Pretoria: Public Service Commission. Schoeman, W.J. 2017. ‘South African religious demography: the 2013 General Household Survey’. HTS Teologiese Studies/Theological Studies, 73(2): 1–7. Seward, B.L. 2001. Health of the human spirit: spiritual dimensions for personal health. Boston: Allyn & Bacon. Shepard, R. 2000. Worksite health promotion and the older worker. International Journal of Industrial Ergonomics, 25(5): 465-475. Sieberhagen, C, Rothmann, S, & Pienaar, J. 2009. Employee Health and Wellness in South Africa: the role of legislation and management standards. SA Journal of Human Resource Management, 7(1): 144. 99 100 Sieberhagen, C., Pienaar, J. & Els, C. 2011. Management of employee wellness in South Africa: employer, provider and union perspectives. South African Journal of Human Resource Management, 9(1): 1-14. South Africa. Department of Labour. 2016. Revised strategic plan 2015 - 2022. Pretoria. South Africa. Department of Labour. 2017. Service delivery improvement plan. Pretoria. South Africa. Department of Public Service and Administration. 2009. Employee Health and Wellness Strategic Framework for the Public Service. Pretoria. Steinmann, S. 2008. Yethu iWellness: Psychosocial Wellness. Services Seta, 3:243. Strydom. H. 2005b. The pilot study. (In De Vos, A.S., Strydom, H., Fouché C.B. & Delport C.S.L. Research at grass roots for the social sciences and human services professions. 3rd ed. RSA, Pretoria: Van Schaik). Van der Merwe, A. 2011. Wellness boosts morale. Occupational Risk: 33-36. Van Wyk, N. 2016. The role of psychological capital in protecting the psychological well-being of individuals working in call centres. Stellenbosch: Stellenbosch University (Thesis – M Com). Walters, L.A. 2015. A mixed-methods exploration of employee attitudes, awareness, and satisfaction with regard to the University Employee Wellness Program. Missouri: Lindenwood University. (Dissertation – D Ed). Welman, C., Kruger, F. & Mitchell, B. 2007. Research Methodology. Cape Town: Oxford University Press. WHO. 2006. The World Health Organisation report - working together for health. http://www.who.int/whr/2006/en/ Date accessed : 11 April 2018. 100 101 Witmer, J.M. & Sweeney, T.J. 1992. A holistic model for wellness and prevention over the life span. Journal of Counselling & Development, 71: 140- 148. Wright, T.A. 2010. The role of employee well-being in organizational research. (In Linley, P.A., Harrington, S. & Garcea, N. eds. Oxford Handbook of Positive Psychology and Work. New York, USA: Oxford University Press, p.143-154). Zhang, J. & Chaaban, J. 2013. The economic cost of physical inactivity in China. Preventive Medicine, 56(1): 75-78. 101 102 APPENDIX A: RESEARCH QUESTIONNAIRE 215 FRANCIS BAARD STREET LABORIA HOUSE EMPLOYEE HEALTH AND WELLNESS OFFICE 424 B PRETORIA, 0001 Dear Participant I, Rivalani Mkansi am currently doing research on the employees’ attitudes, awareness of, participation and satisfaction with the wellness management programme of a national government department Your contribution to this study is extremely important to ensure the success of the project. All employees from post 1 to 16 are requested to participate. This questionnaire has been structured in such a way that it facilitates quick and easy completion. It can take you up to 25 minutes to complete. Your task is to work through the questionnaire as quick as you can and answer the questions as accurately and honestly as possible. Full details are provided on how to complete the questionnaire. The questionnaire consists of the following sections:  Section A – Demographic information  Section B – Employees attitudes towards the wellness management programme  Section C – Employee awareness of the wellness management programme  Section D – Employee participation in the wellness management programme  Section E – Employee satisfaction with the wellness management programme The University Ethics Regulatory Committee has approved the questionnaire and the Director-General has granted me permission to collect data within the Department. Your cooperation in this regard will be highly appreciated Yours faithfully …………………… Rivalani Mkansi Researcher 102 103 INSTRUCTIONS: Kindly complete all sections of the questionnaire. You are required to tick the appropriate statement(s) in each question. SECTION A: BIOGRAPHICAL INFORMATION 1. Gender Male 1 Female 2 2. Age 20-25 1 26-30 2 31-35 3 35-40 4 41-45 5 45-50 6 51-55 7 56 and above 8 3. Race African 1 Indian 2 Coloured 3 White 4 4. Occupational Level Senior Management (SR 13016) 1 Middle Management (SR 11-12) 2 Junior Management (SR 9-10) 3 Supervisors (SR 7-8) 4 Admin and Other Staff Categories (SR 1-6) 5 5. Educational Level Grade 12 1 Diploma 2 Degree 3 Post Graduate 4 103 104 6. Branch Corporate Services 1 Public Employment Services 2 Inspection and Enforcement Services 3 Labour Market Policy Information 4 Operations 5 7. Number of work experience years in the Department 1-5 1 6-10 2 11-15 3 16-20 4 21 and above 5 SECTION B: EMPLOYEES ATTITUDES TOWARDS THE WELLNESS MANAGMENT PROGRAMME Please rate how you feel and perceive the following statements Statements B1 The wellness management programme directly 1 2 3 4 5 benefits me B2 The wellness management programme staff are 1 2 3 4 5 helpful B3 The Department of Labour’s employees benefits 1 2 3 4 5 from the wellness management programme B4 My participation in the wellness management 1 2 3 4 5 programme should lower my monthly health insurance premium B5 I think the Department of labour has a responsibility 1 2 3 4 5 to offer worksite wellness management programme B6 I am better able to maintain my health goals when 1 2 3 4 5 co-workers have similar goals B7 I know someone at work who supports my healthy 1 2 3 4 5 lifestyle improvements B8 My direct supervisor supports my involvement in the 1 2 3 4 5 wellness management programme B9 The Department of Labour encourages/promotes 1 2 3 4 5 wellness at work and at home B10 Administration is supportive of the Department of 1 2 3 4 5 Labour's wellness management programme 104 Strongly Disagree Disagree Neutral Agree Strongly Agree 105 SECTION C: EMPLOYEE AWARENESS OF THE WELLNESS MANAGEMENT PROGRAMME C.1 Are you aware of the Wellness Management Programme offered by the Department of Labour? Yes 1 No 2 C.2 If you answered yes to the question above, how did you know or hear about the programme? (Tick appropriate) C.2.1 New Employee Orientation 1 C.2.2 Articles on Exchange Postmaster 2 C.2.3 iDoL articles 3 C.2.4 EHW newsletter 4 C.2.5 EHW information sessions/Presentation 5 C.2.6 Supervisor or colleague 6 C.3 Which wellness management programmes are you aware of? (Tick appropriate) Wellness management programmes No Yes C.3.1 Physical fitness, exercise and recreation programmes 1 2 C.3.2 Education and awareness programmes for nutrition, weight 1 2 control, medical interventions, life style and chronic diseases C.3.3 Systems for dissemination of wellness information through 1 2 the electronic and print media C.3.4 Preventive and curative programmes such as financial and 1 2 spiritual well-being C.3.5 Psychosocial well-being programmes including counselling 1 2 C.3.6 Organisational development programmes such as workplace 1 2 discrimination, victimisation, harassment, violence and workplace bullying C.3.7 Fair labour practices programmes or workshops 1 2 C.3.8 Programmes and workshops to promote flexible work 1 2 policies and practices and how to maintain a work-life balance C.3.9 Availability of child care facilities 1 2 105 106 C.3.10 Availability of retirement programmes 1 2 C.3.11 Availability of programmes on gender, disability and youth in 1 2 the workplace C.2.12 Healthy sleep therapeutic programme 1 2 C.3.13 Smoking ceaseation programme 1 2 C.3.14 Health screening programme 1 2 C.3.15 Stress management programme 1 2 C.3.16 Management of alcohol and drugs through workplace alcohol 1 2 and drug programmes. C.3.17 Change management programmes 1 2 SECTION D: EMPLOYEE PARTICIPATION IN THE WELLNESS MANAGEMENT PROGRAMME D.1 Have you participated in any of the following wellness management programmes in the past twelve months? Wellness management programmes No Yes D.1.1 I have participated in physical fitness, exercise and recreation 1 2 programmes D.1.2 I have participated in education and awareness programmes for 1 2 nutrition, weight control, medical interventions, life style and chronic diseases D.1.3 I have received wellness information through the electronic and 1 2 print media D.1.4 I have participated in preventive and curative programmes such 1 2 as financial and spiritual well-being D.1.5 I have made use of psychosocial well-being programmes 1 2 including counselling D.1.6 I have participated in organisational development programmes 1 2 such as workplace discrimination, victimisation, harassment, violence and workplace bullying D.1.7 I have attended fair labour practices programmes and 1 2 workshops D.1.8 I have attended programmes and workshops on the promotion 1 2 of flexible work policies and practices and how to maintain a work-life balance D.1.9 I have utilised the child care facilities 1 2 D.1.10 I have attended a retirement programme 1 2 D.1.11 I have participated in programmes on gender, disability and 1 2 youth in the workplace 106 107 D.1.12 I have participated in a healthy sleep therapeutic programme 1 2 D.1.13 I have participated in a smoking cessation programme 1 2 D.1.14 I have participated in a health screening programme 1 2 D.1.15 I have participated in a stress management programme 1 2 D.1.16 I have attended the management of alcohol and drugs through a 1 2 workplace alcohol and drug programme. D.1.17 I have attended a change management programme 1 2 D.1.18 Other programmes in which you have participated in. Specify D.2 What factors would increase your participation in the Department of Labours’ wellness management programme Factors No Yes D.2.1 Proper advertising and communication of wellness 1 2 management programmes D.2.2 Create a culture of wellness management 1 2 D.2.3 Wellness management programmes should be offered free of 1 2 charge D.2.4 Provide incentives 1 2 D.2.5 Making it convenient to participate in wellness management 1 2 programmes for example during office hours D.2.6 Respect employee privacy and guarantee confidentiality 1 2 D.2.7 Support from supervisor to attend 1 2 D.2.8 Leaders and managers should participate to create a 1 2 supportive culture and commitment to wellness D.2.9 Other. Please specify 1 2 107 108 SECTION E: EMPLOYEE SATISFACTION WITH THE WELLNESS MANAGEMENT PROGRAMME Please rate your satisfaction with the following on a scale of 1 to 5 (5 being the most satisfied) Items E.1 The overall wellness management 1 2 3 4 5 programme E.2 The Department of Labour’s wellness 1 2 3 4 5 facilities (gym, walking paths) E.3 Wellness management programme staff 1 2 3 4 5 E.4 Wellness Programmes and workshops that 1 2 3 4 5 you have attended E.5 Communication on events 1 2 3 4 5 E.6 Others: Please specify 1 2 3 4 5 108 Dissatisfied Somewhat not Satisfied No opinion Somewhat Satisfied Satisfied 109 ANNEXURE B : APPROVAL TO COLLECT DATA 109 110 110 111 ANNEXURE C: ETHICAL CLEARANCE 111 112 ANNEXURE D: EDITORS CERTIFICATE 112