Using a Social Capital Framework to Explore a Broker’s Role in Small Employer Wellness Program Uptake and Implementation

Michele Thornton, Kristen Hammerback, Jean M. Abraham, Lisa Brosseau, Jeffrey R. Harris, Laura A. Linnan

Research output: Contribution to journalArticlepeer-review


Purpose: Small employers, while motivated to implement wellness programs, often lack knowledge and resources to do so. As a result, these firms rely on external decision-making support from insurance brokers. The objective of this study was to analyze brokers’ familiarity with wellness programs and to characterize their role and interactions with small employers. Design: Using a newly developed common interview guide (20 questions), protocol and analysis plan, 20 interviews were conducted with health insurance brokers in Illinois, Minnesota, North Carolina and Washington in 2016 and 2017. In addition to exploring patterns of broker interactions and familiarity by segment, we propose a framework to conceptualize the broker-client relationship using social capital theory and the RE-AIM model. Methods: Interviews were transcribed, summarized and a common codebook was established using DeDoose. Themes were identified following multi-rater coding and structured within the framework. Results: Participating brokers reported having a high to moderate familiarity with wellness programs (65%) and a majority (80%) indicated that they have previously advised their small business clients on the availability and features of them. Further, we find that brokers may help eliminate barriers to resources and act as a connector to wellness opportunities within their professional network. Conclusion: New initiatives to promote small employer wellness programs can benefit from examining the influence of brokers on the decision-making process. When engaged and supported with resources, brokers may be effective champions for employer wellness programs.

Original languageEnglish (US)
JournalAmerican Journal of Health Promotion
StateAccepted/In press - 2020

Bibliographical note

Funding Information:
The authors would like to acknowledge the support from the Illinois Prevention Research Center Supporting Policy and Environmental Change. We thank Ashley Phillips for her work on this project. We also extend our appreciation to the brokers and NAHU chapters that participated in this study.

Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by the Center for Disease Control and Prevention / NIOSH [Grant/Contract No: U48 DP005010-01S1(SIP14-031)].


  • health communications
  • interventions
  • workplace wellness

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