Cover: Wellbeing Premium randomised controlled trial for small and medium-sized enterprises

Wellbeing Premium randomised controlled trial for small and medium-sized enterprises

Recruitment evaluation report: Understanding factors influencing firms' recruitment

Published Oct 28, 2019

by Madeline Nightingale, Rob Prideaux, Joanna Hofman, Nadja Koch, Alex Sutherland

Download eBook for Free

FormatFile SizeNotes
PDF file 0.9 MB

Use Adobe Acrobat Reader version 10 or higher for the best experience.

Research Questions

  1. What (if any) aspects of the programme influenced organisations' decision to participate or not participate?
  2. What (if any) aspects of the trial design influenced organisations' decision to participate or not participate?
  3. What (if any) aspects of the recruitment process influenced organisations' decision to participate or not participate?
  4. What other reasons (if any) influenced organisations' decision to participate or not participate?

Good employee health and wellbeing is of key importance to employers and to the economy. Yet, many businesses find it hard to invest in the health and wellbeing of their employees or do not invest at all. These problems are especially true for small and medium-sized enterprises (SMEs). There has been considerable interest in the effect of financial incentives to stimulate change in the workplace environment, but evidence is limited. The West Midlands Combined Authority (WMCA) is running a randomised controlled trial of a financial incentive programme to improve employee health and wellbeing in SMEs in the Wider West Midlands Region. RAND Europe and the University of Warwick have been commissioned by the WMCA to conduct an evaluation of this programme, the Wellbeing Premium Programme. The primary aim of the study is to establish whether SMEs will improve their health and wellbeing offer and achieve higher employee awareness and participation in wellbeing activities in response to a financial incentive offer.

This study, carried out by RAND Europe, focuses on better understanding the reasons behind companies' decisions to participate in the programme, including barriers, motivators and enablers that influence the success or otherwise of recruitment to the randomised trial. The remaining elements of the trial — an impact evaluation and a process evaluation — will measure the efficacy of the programme and explain how it was implemented and will try to achieve an understanding of potential behavioural change in the participating SMEs. The results of these evaluations are expected in 2020.

Key Findings

Administrative burden

  • The views were split between SMEs in terms of viewing additional administrative burden as an obstacle to participate. Similarly, time required from staff to take up health and wellbeing activities was cited as an obstacle for some organisations.

Trial arm allocation and research design

  • Uncertainty related to random allocation to trial arms seemed to have played a role for some organisations in making their decision to participate. Most SMEs were unconcerned about access to data, confidentiality or consent processes.

Uncertainty on requirements

  • Uncertainty about what exactly was required and how the programme would work was one of the major factors that played a role in organisations' decision to not participate. In particular, SMEs wished that information about the programme was clearer about expected benefits, costs involved and requirements for taking part. A one-page summary of this information would be helpful for many.

Capacity and time

  • Nearly all interviewees cited capacity and time constraints as reason for not participating.

Participation in other schemes

  • Participation in another scheme (or satisfaction with the existing health and wellbeing offer) was cited by some SMEs as a reason for not taking part.


  • Conduct market research with SMEs to explore how to approach them and if and how they would like to participate in a future initiative.
  • Complete the design of the intervention and evaluation before starting the recruitment in order to formulate a clear business proposition.
  • Rely on pre-existing connections of your team and/or established business networks and personalise messages when speaking with SMEs, building on existing relations and trust.

Research conducted by

The research described in this report was commissioned by the West Midlands Combined Authority (WMCA) and conducted by RAND Europe.

This report is part of the RAND research report series. RAND reports present research findings and objective analysis that address the challenges facing the public and private sectors. All RAND reports undergo rigorous peer review to ensure high standards for research quality and objectivity.

This document and trademark(s) contained herein are protected by law. This representation of RAND intellectual property is provided for noncommercial use only. Unauthorized posting of this publication online is prohibited; linking directly to this product page is encouraged. Permission is required from RAND to reproduce, or reuse in another form, any of its research documents for commercial purposes. For information on reprint and reuse permissions, please visit

RAND is a nonprofit institution that helps improve policy and decisionmaking through research and analysis. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.