In the opening of the American Psychological Association’s 2013 Work and Well-Being Chicago Conference, Dr. David Ballard, conference chair, noted that year after year, people report work as one of the top three stressors in their lives. The top five sources of workplace stress are:
- Low salary
- Lack of opportunities for growth and advancement
- Long hours
- Uncertain or undefined job responsibilities
Sure, it’s a stretch, and there are likely no organizations that could claim this status at present, though some are making progress. But isn’t that what a great vision is, a clarion call?
Most employers justifiably approach employee wellness as a means of enhancing business performance through indicators like reduced absenteeism and medical costs. Baicker and colleagues found that medical costs fall about $3.27 for every dollar spent on employee wellness programs, and absentee day costs fall by about $2.73 for every dollar spent. Most of the focus of workplace wellness to date has been on two costly lifestyle diseases, smoking and obesity. That’s a long way from our vision of flourishing employees, but these health issues are costly and can be improved.
Well-being is a journey, whether embarked upon individually or organizationally, and lessons from the following four conference sessions offer possible pathways along a workplace wellness continuum.
In the session, Growth and Impact of Financial Incentives in Worksite Wellness, Dr. David R. Anderson from StayWell Health Management, shared trends in the use of incentives to enhance employee wellness. The use of financial incentives is increasing, with 68% of employers stating that they used health related incentives in 2012, up from 36% in 2009.Although most employers report that incentives are working, Dr. Anderson puts this into perspective by agreeing that most financial incentives can increase compliance with simple behavior changes in the short term, but that long-term change requires intrinsic motivation in the employee, which is often not generated from short-term incentives. There are ways that motivation can begin extrinsically through incentives and then become intrinsic with the addition of cultural and communications components, however. Two examples he gave were national changes in the use of seat belts and in the reduction of littering. A similar, three-pronged approach (incentive, culture, communication) could be used for wellness success in the workplace.
Dr. Anderson sees promise in incentives trends. Initially, incentives were given for program participation. For example, participate in a smoking cessation or weight loss group and receive a financial incentive. A more recent trend is introduction of outcome-based incentives, where one must demonstrate smoking cessation or lost weight for the full incentive to be realized. One of the problems with the outcome-based incentives is that they tend to work best for people who are already committed and near a goal, such as a healthy Body Mass Index (BMI). In this sense, the organization is providing incentives for their relatively healthy employees to become healthier.For broader reach, Anderson recommends progress-based incentives. Biometrics are established at the beginning of the program, and incentives are rewarded based on movement along the health continuum. This approach is more likely to encourage those who most need well-being improvements. It may also lead to greater intrinsic motivation over time because the goals and targets are more customized.
Looking at decades of research, Dr. Anderson concludes that organizational culture trumps financial incentives for long-term improvements. Healthy cultures are built with supportive leadership practices that share responsibility for wellness between the employee and employer. These practices meet employees where they are relative to wellness and then nudge them toward increased well-being at each step along their journeys. He foresees employer incentives being integrated into health plan costs, where the reality of the shared responsibility is made clear, reinforcing the link between personal behavior and the cost of the employee’s health care plan.Workplace Culture
In her session, Healthy Habits, Healthy Employees, Dr. Cindy Wang Morris shared how the University of Colorado Anschutz Medical Campus is creating a culture of health by cultivating healthy habits by employees. The strategy for creating a program that is engaging, active and fun for employees involves, as Dr. Morris says, “Opening as many doors to wellness as possible.” This means beginning with physical and emotional well-being as the core of the program, but also considering financial, intellectual, occupational, social, spiritual and environmental “doors” to wellness, too, because a change in one area can often lead to changes in other areas.Dr. Morris is the first to admit the difficulty of finding just the right key to wellness for yourself, and even more so for a diverse population of employees. Because of this, Anschutz Medical Campus is basing their model on Prochaska’s model of Stages of Health Change, with offerings for those at the earliest, pre-contemplation stages through to those who have already made some changes and are now at the maintenance stage.
As far as the main philosophy of cultivating healthy habits, Dr. Morris uses a model for mindful living as a key. First there is a process of envisioning what we want, and then mindfully listening to our emotions, and creating a practice of current and new behaviors to support our vision. This process can work at any stage of change. Add in friends for support and a little fun, and the elements for healthy habits are all there!
Blending Technology and Customization for Successful Well-Being Outcomes was offered by Briana Boehmer from Salus Corporate Wellness. In her opening, Ms. Boehmer stated that each workplace is tasked with providing the best wellness programming within resource constraints. In the perfect world, all the customized resources needed to meet the needs of all employees would be available, but wellness dollars are competing with other important organizational needs. What to do?Ms. Boehment presented four successful case studies from small- to medium-sized organizations that combined onsite programs, biometric measures, follow up technology tracking, and coaching systems. In each case, technology solutions were able to fill in needed motivational and monitoring services more rapidly and at lesser costs than onsite coaches or physicians could do. Online tools give the ability to customize to each employee and to coach to scale, without having to meet face-to-face repeatedly.
There are two key points in developing integrated wellness solutions. First, even though there may be multiple components (onsite, metrics, tracking, technologies, and so on) programs should be branded under one umbrella program to minimize confusion. All their components are within the Healthy Now program, for example. Secondly, even though the metrics and online components have a basis in individual measurement and customized solution design, cooperative support systems should be built in to increase likelihood of success, either through online social media groups or in-person.Partnership Approach
Finally, Cali Williams Yost, from Work+Life Fit, Inc. presented her vision and tools for Work+Life Fit Skills for Employee Success On and Off the Job. Ms. Yost presented a vision for what she has termed Work+Life Fit, replacing the traditional word “balance,” which places too much of the burden on the individual and lets the organization off the hook. Instead, Ms. Yost encourages the creation of wellness partnerships between employers and employees to gain a best Work+Life Fit, and uses the concept of flexibility as a key.The philosophy is demonstrated in resources and tools. There is an employer and an individual portal within Work+Life Fit. On the individual side, the tools encourage a setting of life fit priorities, which include work, and then tweaking life on a regular basis to enhance the fit (or reevaluate your priorities) using an app called Tweak It. The work includes discussions with your employer about the career portion of your life.
On the employer side, the idea is to teach all employees the fundamentals of well-being using Work+Life Fit, and then engage in conversations and actions to create mutually beneficial goals and outcomes. The ideas here build on the shared responsibility for the wellness concept, on the creation of a wellness culture, and on the blended model for organizational and technology resources. The addition of a partnership between employer and employee is what takes it further toward the vision of workplaces as a source of well-being!
Baicker, K., Cutler, D., & Song, Z. (2010). Workplace wellness programs can generate savings. Health Affairs 29(2): 304-311.
TowersWatson (2010). The Health and Productivity Advantage, 2009/2010.
TowersWatson (2011). Use of Rewards and Penalties to Drive Employee Health Jumps During 2012.
Prochaska, J. O., & Velicer, W. F. (1997) The Transtheoretical Model of health behavior change. American Journal of Health Promotion, 12(1), 38-48. Abstract.
Prochaska, J.O., Norcross, J.C. & Diclemente, C.C. (1994). Changing for Good: A Revolutionary Six-Stage Program for Overcoming Bad Habits and Moving Your Life Positively Forward. New York: HarperCollins.
Allen, J. & Shaar, M.-J. (2013). Wellness Doesn’t Happen in a Vacuum. Positive Psychology News.
Shaar, M.J. & Britton, K. (2011). Smarts and Stamina: The Busy Person’s Guide to Optimal Health and Performance. Philadelphia, PA: Positive Psychology Press.
The first is courtesy of Jan Stanley. Others are from speaker web sites or
via Compfight with Creative Commons licenses.
Walking to work courtesy of vonderauvisuals
Partnership courtesy of LollyKnit
The image of the transtheoretical change model is from the Peluuri Gambling Hotline.