The Wellbeing Paradox
Over the past decade, employers have invested heavily in workforce wellbeing.
- Health portals have been launched.
- Employee assistance programmes have been expanded.
- Fitness initiatives have been introduced.
- Mental health resources have been made available.
- Digital wellbeing platforms have become increasingly common.
Yet despite this investment, many organisations continue to ask the same question:
“Why aren’t we seeing the results we expected?”
It is a reasonable question.
After all, if access to wellbeing support is improving, surely outcomes should improve too.
However, the evidence suggests that the relationship between availability and outcomes is far more complicated than many organisations assume.
The reality is that wellbeing programmes rarely fail because support does not exist.
More often, they fail because people do not engage with that support consistently enough to create meaningful change.
This distinction sits at the centre of a growing body of workplace wellbeing research and has significantly influenced the way we think about workforce health at Trigo.
The Assumption Most Wellbeing Programmes Make
Many workplace wellbeing initiatives are built around a simple assumption.
If services are made available, employees will use them.
The logic appears reasonable.
Provide access to:
- Health information.
- Wellbeing resources.
- Clinical support.
- Educational content.
and positive outcomes should follow.
The problem is that human behaviour rarely works this way.
Availability does not automatically create participation.
Participation does not automatically create behaviour change.
And behaviour change does not automatically create organisational outcomes.
Each stage requires deliberate effort.
The evidence increasingly suggests that many wellbeing programmes focus heavily on the first stage while paying insufficient attention to the others.
As a result, organisations often measure what they have provided rather than what employees are actually doing.
This creates what might be described as the wellbeing paradox.
- Programmes exist.
- Support exists.
- Yet engagement remains limited.
What the Research Tells Us
A growing body of evidence has examined the effectiveness of workplace health interventions.
One of the most useful reviews comes from Howarth and colleagues (2018), who examined digital health interventions within workplace settings.
The review found evidence that digital interventions can positively influence health-related behaviours.
However, the authors also identified a recurring challenge.
Sustained engagement was often difficult to achieve.
This finding is important.
The issue was not necessarily the quality of the intervention itself.
The issue was participation.
Similar observations emerge from the work of Sevic and colleagues (2023), who reviewed eHealth interventions targeting employee health behaviours.
The review identified positive effects across multiple health-related outcomes but again highlighted engagement as a critical factor influencing effectiveness.
In simple terms: people must participate if programmes are to succeed.
This may seem self-evident, but it has significant implications for how organisations design wellbeing strategies.
Why Participation Matters More Than Access
One of the strongest themes emerging from the evidence base is that participation is often a leading indicator of success.
This idea appears repeatedly throughout the literature reviewed in this article series.
In Engagement Is Not Luck: What Digital Health Research Teaches Us About Behaviour Change, we explored how engagement influences behaviour change.
In Why Supported Self-Care Works Better Than Passive Treatment, we examined the role of supported self-care.
Both concepts depend upon participation.
The same principle applies within workforce wellbeing.
An employee cannot benefit from:
- Educational content they never access.
- Coaching they never attend.
- Programmes they never join.
- Support they never use.
This may seem obvious.
Yet many organisations continue to evaluate wellbeing programmes according to availability rather than utilisation.
The evidence increasingly suggests that participation deserves equal attention.
Perhaps more.
What Successful Programmes Have in Common
Research by Shiri and colleagues (2023) provides additional insight into this challenge.
Their review examined workplace interventions designed to improve health and wellbeing among health and social care workers.
The findings suggested that interventions were often more successful when they:
- Encouraged participation.
- Supported physical activity.
- Combined multiple components.
- Maintained ongoing engagement.
This is an important observation.
The strongest programmes rarely rely upon a single intervention.
Instead, they create ecosystems of support.
- Physical activity.
- Education.
- Communication.
- Behavioural support.
- Professional guidance.
These elements work together.
This mirrors a recurring theme across the wider evidence base.
The most effective interventions are often integrated interventions.
Why Information Rarely Changes Behaviour
Historically, many workplace wellbeing programmes focused heavily on awareness.
The assumption was simple.
If employees understand health risks, healthier behaviour will follow.
Research increasingly challenges this assumption.
Knowledge remains important.
However, knowledge alone rarely creates sustainable behaviour change.
Most employees already understand the importance of:
- Physical activity.
- Sleep.
- Stress management.
- Healthy lifestyle choices.
The challenge is not awareness.
The challenge is implementation.
This is where engagement becomes critical.
Research reviewed by Milne-Ives et al. (2023) demonstrates that people are more likely to remain involved when interventions include:
- Goal setting.
- Progress tracking.
- Feedback.
- Support.
These mechanisms help bridge the gap between intention and action.
Without them, even well-designed wellbeing programmes may struggle to maintain momentum.
The Engagement Gap
At Trigo, we often describe this challenge as the engagement gap.
The gap between making support available and helping people participate.
Many wellbeing initiatives are designed around resources.
Far fewer are designed around engagement.
This distinction matters because engagement is often where outcomes begin.
Research reviewed by Edwards et al. (2016) and Alzghoul et al. (2024) suggests that behavioural reinforcement, progress visibility and recognition can positively influence participation.
These findings are particularly relevant within workplace settings.
- Employees are busy.
- Competing priorities are constant.
- Attention is limited.
The challenge is not simply creating support. The challenge is creating experiences that people return to.
Why Wellbeing Must Become Part of Everyday Work
Another important lesson emerging from workplace health research is that wellbeing cannot remain separate from everyday life.
Traditional programmes often operate on the periphery of organisational culture.
Employees are encouraged to engage when they have spare time.
The evidence increasingly suggests that participation improves when wellbeing becomes integrated into everyday routines.
This does not mean constant intervention.
It means creating opportunities for small, sustainable actions.
The most successful wellbeing strategies often focus less on dramatic transformation and more on consistent participation.
This aligns closely with the broader principles of supported self-care explored earlier in this article series.
Meaningful outcomes frequently emerge from small actions repeated consistently over time.
Why Employers Need Better Measures of Success
Many organisations continue to measure wellbeing programmes using relatively simple metrics.
- Number of users.
- Number of logins.
- Number of resources accessed.
These measures provide useful information.
However, they rarely tell the full story.
The evidence suggests that organisations should also pay attention to:
- Participation rates.
- Behavioural activation.
- Ongoing engagement.
- Programme completion.
- Sustained involvement.
These measures often provide a better indication of whether meaningful behaviour change is occurring.
The distinction is important.
A programme can be popular without being effective.
Equally, a programme can generate meaningful outcomes without generating large volumes of activity.
Understanding this balance is becoming increasingly important for employers seeking value from wellbeing investments.
How This Influenced Trigo
The workplace wellbeing literature has had a significant influence on the development of the Trigo platform.
The evidence reviewed by Howarth et al. (2018), Sevic et al. (2023) and Shiri et al. (2023) repeatedly points towards a common conclusion.
- Participation matters.
- Engagement matters.
- Behaviour change matters.
This influenced several design principles within Trigo.
- Communication is viewed as a strategic capability rather than a messaging function.
- Tracking is viewed as a behaviour-change tool rather than a reporting feature.
- Professional support is integrated into broader participation pathways.
The objective is not simply to provide services. The objective is to help people remain involved. This distinction is fundamental.
The evidence suggests that outcomes emerge when people participate.
The platform is designed to support that participation.
From Wellbeing Programmes to Wellbeing Systems
Perhaps the most important lesson emerging from the research is that organisations should stop thinking exclusively in terms of wellbeing programmes.
Programmes are finite.
- They start.
- They run.
- They end.
Health does not work this way.
Workforce wellbeing is an ongoing process.
This is why we increasingly think in terms of wellbeing systems.
Systems that support over time:
- Participation.
- Engagement.
- Communication.
- Self-management.
- Access to expertise.
This perspective aligns closely with the broader shift towards digital wellbeing described by Smits et al. (2022).
The future is unlikely to be defined by isolated interventions.
It is more likely to be defined by connected ecosystems of support.
Looking Forward
The evidence reviewed by Howarth et al. (2018), Sevic et al. (2023) and Shiri et al. (2023) paints a consistent picture.
- Workplace wellbeing programmes can create value.
- Digital interventions can influence behaviour.
- Participation can improve outcomes.
However, success depends upon more than availability.
- It depends upon engagement.
- It depends upon participation.
- It depends upon creating conditions that help people remain involved long enough for meaningful change to occur.
At Trigo, these findings have played an important role in shaping our approach to workforce wellbeing.
Because ultimately, wellbeing programmes do not fail because support is unavailable.
They fail when participation never becomes part of everyday life.
References
- Howarth, A., Quesada, J., Silva, J., Judycki, S., Mills, P. R., & Schiavo, J. H. (2018). The Impact of Digital Health Interventions on Health-Related Outcomes in the Workplace: A Systematic Review. Digital Health, 4.
- Sevic, S., Müssig, M., Bredemeier, J., et al. (2023). Effectiveness of eHealth Interventions Targeting Employee Health Behaviors: Systematic Review. Journal of Medical Internet Research, 25:e38307.
- Shiri, R., Turunen, J., Kausto, J., et al. (2023). Effectiveness of Workplace Interventions to Improve Health and Well-Being of Health and Social Service Workers: A Narrative Review of Randomized Controlled Trials. Journal of Occupational Health.
- Milne-Ives, M., et al. (2023). Potential Associations Between Behaviour Change Techniques and Engagement With Mobile Health Apps.
- Edwards, E. A., Lumsden, J., Rivas, C., et al. (2016). Gamification for Health Promotion: Systematic Review of Behaviour Change Techniques in Smartphone Apps. BMJ Open.
- Alzghoul, A., Alkhazaleh, Z., Alkhawaldeh, M., et al. (2024). The Effectiveness of Gamification in Health and Wellbeing: A Systematic Review and Meta-Analysis. The Open Public Health Journal.
- Smits, M., van Velthoven, M. H., Kotz, D., et al. (2022). From Digital Health to Digital Well-being: Systematic Scoping Review. Journal of Medical Internet Research.