The term wellness has been in and out of vogue in the fitness industry during the past 25 years, but now wellness and alternative health programs are gaining increased acceptance, not only with the public, but also with the traditional medical community.

In fact, the National Marketing Institute's (NMI) Top 10 Lifestyles of Health and Sustainability Trends for 2009 listed "alternative" as a top trend that officially has gone mainstream.

"With the increased usage of alternative health care practices, physicians, insurers, employers and consumers are embracing a more preventative approach to health," NMI says. "From alternative fuels to alternative apparel, choices and options challenging the status quo across industries are being embraced."

Mirroring that trend, many fitness facilities are embracing wellness again, and using a holistic approach to combat the obesity epidemic, as well as soaring member stress rates triggered by the economy. Clubs are finding they can position themselves as a necessity, even in troubled times, with a variety of fitness, nutritional, mind/body and social programs.

"Wellness is a future place of growth for fitness clubs that can help their business stay alive," says Donna Hutchinson of On the Edge Fitness Educators in North Vancouver, British Columbia, Canada. "I think wellness is not a new concept, but the way it applies to the fitness industry now is that people are finally starting to get that it's not just about how I look, but also about things like brain health and spirituality."

Mike Alpert, president and CEO of the Claremont Club, Claremont, CA, agrees. In addition to a full-service day spa, Alpert's club includes medical rehabilitation facilities operated in conjunction with local hospitals.

"Wellness is something that I've always believed in as an owner/operator of a club, and even now in my new role," Alpert says. "And today with the economy the way it is, the obesity epidemic and rising health care costs, wellness is really coming into its own."

While the term wellness means different things to different people, Melissa Baumgartner of Midwest Fitness Consulting LLC, St. Louis, MO, says wellness encompasses seven dimensions: social, spiritual, intellectual, emotional, environmental, physical and vocational. (See "The Seven Dimensions of Wellness" article for more information.) From her perspective as a fitness trainer and wellness coach, Baumgartner also sees a shift in focus ahead for the fitness industry.

"To me, fitness is a very small piece of overall wellness. Fitness is physical activity and exercise, while wellness includes social, spiritual and even vocational aspects," Baumgartner says. "A fitness professional tells their client what to do with a fitness plan, but that hasn't been working if you look at the obesity epidemic. But if we shift the paradigm and ask clients what they want to do, we can make a plan together to create a permanent lifestyle change."

However, to truly be a wellness resource, clubs must have more than a token yoga class or other programming, Hutchinson says. She notes that when things get tough, people tend to see their fitness memberships as unnecessary expenses.

"If a business is going to understand wellness, they really need to embody it, not just have programming," Hutchinson says. "For instance, when someone walks in the door, they should be treated well and get the same feeling they would when they walk into a spa. It just feels good."

Boosting Adherence

Many club owners are seeking ways to boost member retention rates. Some facilities find that by combining additional wellness aspects — like intellectual and social — with physical fitness, they can boost adherence rates and literally keep members coming back for more.

Researcher Jim Anessi, director of wellness advancement for the YMCA of Metropolitan Atlanta, is studying how mindful behavioral changes can increase success with the Y's fitness programs. His Coach Approach program is in use at YMCAs in 19 cities across the country.

"With the Coach Approach program, the primary measurement is adherence," he says. "The dropout rate for a new exerciser during the first three to six months is 60 percent, but with Coach Approach, it's 30 percent. We're finding [that] just giving people the right information for physical training has no connection with adherence."

The Coach Approach program teaches participants self-management skills to get their brains in line with a fitness plan, then offers social support to help people stay on track. This holistic approach to fitness encourages members to follow through on their workout plans.

Jim Ellis, director of design development and medical integration of Power Wellness in Addison, IL, says his hospital and university clients also are moving beyond yoga and tai chi to offer cognitive counseling like guided imagery and other mindful-based stress reduction techniques.

"We're definitely seeing an increased interest in wellness, not only in clients and communities, but in the design of facilities," he says. "We're seeing an increase in the number of studios put in to accommodate yoga, tai chi and Pilates. And we're seeing an increase in space dedicated to education and instruction on fitness and wellness, as well as contemplative spaces like Zen gardens and Zen pathways to address the desire people have to center themselves."

Since hospitals are healing centers by design, they are a natural fit for wellness programs. However, Hutchinson says some fitness facilities may be slower to board the wellness train.

"In most of the huge chain clubs, I don't see that message changing from get fit quick, but within some clubs, there is more of a message of feel good and have more energy," she says.

Corporate Wellness

The corporate world in particular is embracing wellness in an effort to keep employees healthy, Baumgartner notes.

"In my experience, it's easier to converse about wellness in a corporate setting than in a gym setting," she says, noting that she organizes a variety of events when she's been hired as a corporate wellness coach, such as one-on-one coaching, lunch-and-learns and health fairs. "Most corporations receive discounts on health insurance if they have a wellness plan in place," Baumgartner says.

The 2008 MetLife's Sixth Annual Employee Benefits Trends Study found that 57 percent of employers with 500 or more employees are providing a wellness program, up from 49 percent in 2006. In fact, 71 percent of major U.S. employers were using incentives to promote employer-sponsored health and wellness programs in 2008, per a survey by the ERISA Industry Committee, the National Association of Manufacturers and IncentOne.

Some fitness facilities even are focusing on employee wellness to increase staff retention rates and promote better customer service.

"Our main goal is to help people live healthier lives," says Alpert. "It's not about just looking at how can I make a ton of money at this? Our mission isn't to make a fortune. Our mission is community driven. First, we take care of our staff, then our staff takes care of our members, and the members are better able to take care of the community."

The Claremont Club offers wellness programs, such as nutritional counseling, to staff and members alike. Plus, it allows employees to engage in wellness programming on the clock. In turn, the club has a staff retention rate of 95 percent, made up of mostly part-time, hourly employees. By cutting down on staff recruitment and training costs, the club saves money and positively affects its bottom line.

Military Facilities

The military also is reaping the benefits of wellness programming. To keep troops centered and ready for duty, military fitness facilities are embracing a broader view of fitness and wellness, says Alison DeCaro, health promotion manager for the Eglin Air Force Base (FL) Health & Wellness Center.

"When you think of the military, you usually just think of fitness, but there's more to it," DeCaro says. "Our Air Force Material Command actually has a slogan: Wellness is an attitude. And within that concept, we highlight physical, spiritual, emotional and social aspects. We know you can tell everyone to work out on so many days a week, but sometimes life gets in the way. We're teaching them strategies for how to fit wellness into their lives."

In addition to fitness regimens, DeCaro and her team offer stress-reduction classes, tobacco cessation support and nutritional counseling, including a special Performance Power class to teach soon-to-be-deployed troops how to eat for fuel, as well as for their health.

The Kids on the Go program at Eglin Air Force Base teaches parents and children about nutrition and healthy lifestyle choices. For instance, participants might make healthy snacks together or play active games to help combat childhood obesity.

Anessi also designed a Youth Fit for Life program for YMCAs that encourages children to get active. The after-school program includes physical activity, nutritional programming and behavioral programming designed to increase physical activity outside of school. A five-year research study of Youth Fit for Life found improvements in the children's mood and self-esteem, as well as significant decreases in body mass index.

Targeted Wellness

Targeting wellness programming to specific demographics is a great way to build loyal members and develop a sense of community. To assist her aging population, Peggy Buchanan, director of fitness and aquatics at Vista del Monte Retirement Community in Santa Barbara, CA, and senior spokesperson for IDEA, includes programming designed to prevent falls, improve posture and re-engage deactivated muscles. Buchanan says her facility is one of the first in Santa Barbara to use the Redcord program.

"Redcord is a therapeutic approach to activating deactivated muscles to reduce pain," she says. "The whole concept is based on suspension on red cords. They do a quick assessment to see which muscles aren't activated. Then they can pinpoint and reactivate those muscles, usually in one to four sessions."

The Redcord program was developed in Norway and was designed to improve the interaction between the brain, receptors and muscles. It uses slings and elastic cords in a neuromuscular activation treatment program to strengthen patients' muscles and enhance passive range of motion.

Almaden Valley Athletic Club in San Jose, CA, features a More Chiropractic and Rehabilitation clinic onsite to help members improve range of motion.

"We've had a More clinic for about five years," says MaryAnn Smith, wellness director at Almaden Valley. "The gentleman in charge of it is both a chiropractor and a physical therapist who integrates his program into a fitness routine. Then, we turn them over to our trainers."

Although most of the clients at the More clinic are already Almaden Valley members, Smith organizes other non-gym related wellness activities for the club that serve as member outreach.

"We include activities, trips and lectures in our programming to help people get their brains working, as well as their bodies," she says. "We did a holiday train ride in December through Niles Canyon, and when we do things like that, members bring their friends and it becomes more like outreach."

More traditional wellness amenities, such as day spas, also serve as new member outreach, Alpert notes.

"At any given time, 53 to 56 percent of the people that use our day spa are not members, but we do get crossover from people who become members, not only from our spa, but also from our summer camps and swimming programs," Alpert says.

The Claremont Club also works with area hospitals on physical therapy programs, including a spinal cord injury program for nonmembers. But working with the medical community can take time to get started, he notes.

"We've worked really hard for 11 years to make strategic alliances with the medical community," Alpert says. "We work with three hospitals and several physicians in the community. It takes a long time to establish these relationships, but it's a great source for referrals."

Power Wellness also works with the medical community. Ellis says that outreach efforts must be about programs with proven results to impress doctors and hospitals.

"We're finding that even among traditional medical associations there's a growing awareness that wellness programs have a positive effect on people," Ellis says. "We offer them evidence-based programs that have been shown through outcome-based data to have positive outcomes for people."

To connect with the medical community, Ellis says his company does one-on-one marketing to show them how a wellness approach can positively affect patients. His company also employs direct mail marketing, radio ads and traditional advertising to reach its target audience. However, he notes that many of the facilities they work with serve Baby Boomers, who generally have a higher level of education that may contribute to an interest in wellness.

The wellness program at Almaden Valley originally began as a senior citizen outreach program, then expanded to include a broader population, like Baby Boomers.

"In 2001, the owners of Almaden Valley asked me if I would start a senior wellness program that we've since expanded to include everybody," Smith says. "Baby Boomers don't want to consider themselves seniors."

To spread the word about wellness programs, Smith employs targeted e-mails, as well as e-bulletins and a wellness bulletin board in the lobby.

Although incorporating wellness into a club's programming may seem daunting, Baumgartner notes that many clubs already are doing so without being aware of it.

"I think that a lot of gyms have a wellness program in place; they just don't think to call it that," she says. "Gyms have a physical piece of the puzzle, but maybe they also have a book club that speaks to the intellectual side of wellness, or schedule a yoga class that addresses the spiritual side, or a recycling program that's the environmental piece."

Whether a club needs to expand existing wellness programs, or start from scratch, offering members a well-rounded approach to fitness and wellness can cement their memberships as "must have" expenses, even during a recession.