Jan Stanley, MAPP '10, was a director of learning systems and leadership development before leaving the corporate world to create her own map of a road less taken. Jan's focus is now squarely on her passion of applying positive psychology through the use of poetry, mindfulness, collaboration, and ritual, woven together into ceremonies of well-being. Jan served as a facilitator for the U.S. Army Master Resilience Training program. She is a faculty member of the Celebrant Foundation and Institute, where she teaches others about the beauty and benefits of ceremony. Full bio. Jan's articles are here.
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
- Workload
- 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.
Incentives
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!
Interactive Solutions
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 ApproachFinally, 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!
References
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.
Photo Credits
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.
7 comments
Jan – this is really lovely. It looks like it was a very full and fulfilling conference! When I read your article, it sounded like you were really trying to do justice to each session, but what I *really* want to know (because I always value your perspective on such things) is what stood out for you? There’s never a single magic wand solution, but were there any big “aha” moments for you? Or any findings that you’d want the world to know? Any great nudges? Thanks!
Thanks, Lisa. What a great, thought provoking question! Two things come to mind that could possibly be fodder for even more exploration.
First,there is a huge opportunity for the application of the science of positive psychology in workplaces. This might seem like, and probably is, a rather obvious statement, but it is truly the thing that most stood out for me after attending the APA Work and Well-Being Conference. The presentations featured many approaches with some successes in enhancing employee wellness, which is great. The presenters – whether they were representatives from the organizations, or were consultants working with the organizations, were knowledgeable about employee wellness and well-intentioned. However, the idealist in me couldn’t help but notice that many programs are at the early stages of really creating the conditions for fourishing employees, and that most were beginning with physical wellness. There might be many reasons for this – the lack of physical health is costly to an employer, the parameters are relatively easy to measure, wellness programs can be administered by a central office, like human resources, etc.
Second, there seem to be at least two major areas of potential for creating an environment of well-being within a workplace. The one featured most at this conference is what I’ll call Employee Wellness. This area is targetted at individual employees and (therefore?) is often run by the workplace Human Resource function. Wellness progams feature physical health and wellness, but could also include other areas. If it is a good Employee Wellness program, and many at the conference are, it is tied to strategic goals, measured, and fully supported by senior leadership. The second area of activity is what I’ll call On-The-Job Well-Being, which is tied more closely to the work performed by the employee and (therefore?) is more suited for implementation by local management, in partnership with their employees, and perhaps supported by the Organization Development function. This area would include things like job progression, finding meaning in work and using one’s strengths, to name only a few, and could become an umbrella category under which employee engagement programs might fit. Both areas could use positive psychology research in program design.
So, putting points one and two together, I could envision a progression in becoming a Workplace That is a Primary Source of Well-Being (my article title). Think of a stairstep where the first step is disparate Employee Wellness programming that might be tied to incentives, the second step might be more strategically targeted and wholistic Employee Wellness programming and later steps could be strategically linked Employee Wellness programs that are integrated with the On-The-Job Well-Being programs, lead by wise and consitent leadership practices, culminating in a Workplace of Wellness and Well-Being.
Newswise — (Orlando – April 30) As more and more employers use outcomes-based incentive programs to encourage their employees to participate in workplace wellness programs, they need to adopt best practices to ensure such programs are both fair and effective for all. That was the overarching message from workplace wellness experts who participated in a panel discussion on the second day of the annual meeting of the American College of Occupational and Environmental Medicine (ACOEM) being held here this week. Titled “Workplace Wellness and the Use of Outcomes Based Incentives,” the panel offered advice for employers to ensure their incentives programs maximize the health improvement results such programs are designed to achieve, while also providing proper protection for employees against discrimination or unfairness and impacts on health care coverage.
Hi Jan:
I love the concept of wellbeing in the workplace. I use alot of PP in the workplace to focus on wellbeing and have found that it is an interesting journey to get employers to appreciate the concept of “wellbeing” as part of or separate from the more traditional medical insurance based “wellness” concepts. Communicating the value proposition in language that both appeals to the bottom line and inspires to the organizations higher purpose seems to help. Thanks for highlighting this!
Jan, this is a great post, highlighting that employee well being is much more than fitness programs. It’s a comprehensive approach within an organisation that is a leadership issue. Sure, employes can take individual approaches to their personal well being, but the culture and leadership, combined with collaborative approaches to build well being into the work, will have far more traction. Thanks Jan!
To keep incentive structures compliant with health laws and regulations, employers should give all participants an equal opportunity to earn the reward and not design specific incentives for any particular segment. Legal experts recommend having an alternative available to help individuals achieve their goals and for those unable to reach a goal. For example, they advise employers with premium surcharges for smokers to offer smoking-cessation programs and tools through their wellness program. For BMI goals, employers should consider offering employees with penalized BMIs a chance to enroll in a weight loss program or to make improvements to earn the premium discount.
As our industry continues to evolve, new evidence is emerging in support of including spouses in wellness programs that include the use of outcomes-based incentives. Adding spouses to your wellness program makes sense for many reasons, the obvious being that some spouses may not have the benefit of health education and programs in their work setting. Also, many employers report a large percentage of high cost cases are coming from spouses, and a disproportionate amount of claims spending is coming from spouse and dependent claims. Therefore, spouse engagement in wellness can be a critical part of the overall success of your employee benefits strategy.