A fallacy is a false notion… and in wellness we have many. Some we invent out of thin air then work hard to justify, while others arise from academic theories thinly supported by scientific study. Each is relatively harmless in and of itself, but added together they consume time and budgets, leaving little if any resources available for creating an environment where well-being can flourish.
What you believe may be holding you back:
- If people understand their disease and mortality risk, they’ll naturally want to change their behavior. If 30 years of Health Risk Appraisals have taught us nothing else, it should be clear that gimmicks like risk age don’t do much to persuade people toward healthier habits. There may be other good reasons to conduct HRAs, but influencing population health isn’t one of them. Spend an afternoon reviewing medical claim data once every couple of years to confirm what you already know: People need to move more, eat more vegetables, and sleep better.
- Employees need an incentive/disincentive to improve health habits. The long slide toward bribery turned penalty began more than 15 years ago when Johnson & Johnson reported amazing results for paying people to complete an HRA. Duh. The idea that completing a 20-minute survey for cash was some big win for wellness seems laughable now, yet the practice remains more widespread than you’d think. Organizations often have the assessment as the first in a series of steps to “earn” reduced premiums and/or HSA contributions. The inevitable failure of these schemes to reduce healthcare costs routinely morphs into punishment for not achieving health outcomes — saddling companies with legacy expense and a significant workforce portion less engaged than the day they came to work. The moment you introduce money for health improvement is the instant you change the dynamic from this is something I want to do for myself to this is something I should do for the money. And there goes your opportunity to create lasting change in the population.
- Management support is vital to a successful wellness program. Management opposition will kill a wellness movement faster than you can say show me your ROI. But support doesn’t mean your CEO needs to be out leading every 5K run. In fact, depending on management’s reputation and the organization’s culture, a quietly supportive corner office could be the ideal situation. Too many health promoters lament the fact they can’t get upper management to participate in wellness programs. So what? They’re busy… give them a break. Remember: Your goal isn’t participation; your goal is health. If your top managers are going for a morning jog, eating healthfully, and managing stress appropriately, they’re modeling the behavior you want. Showing up on your health message board would be nice, but ultimately is inconsequential to your mission.
- Behavior change happens in stages and/or can be programmed with small steps. People go through a wide range of thoughts, emotions, and degrees of motivation and confidence, but not necessarily in 5 neat linear steps from pre-contemplation (which is kind of silly when you think about it) to maintenance. While we can be trained to do almost anything in a controlled environment, we’re not binary or in the state pen. Changing long-ingrained health habits resulting from messy social, psychological, and emotional influences can’t be reduced to a simple 3-part formula. We want it to be that simple and understandable, but anyone who has actually practiced health coaching or tried to influence population health outside the lab knows first hand how disheveled the process truly is.
Ultimately, someone makes a conscious decision to change a health behavior at a deep level. Yes, managing triggers, controlling environment to the extent possible, and positive reinforcement all can play a part. But the bottom line is, and always will be, this: Each individual must decide it’s in their best interest to adopt habits that contribute to well-being and eschew choices that detract from health. In your role as wellness professional, you can contribute to an atmosphere that makes that more or less likely. That’s your choice.
Dean Witherspoon
Chief collaborator, nudger, tinkerer; leads the most inventive team creating well-being and sustainable living programs. Reach out if you’d like to talk about employee well-being, emotional fitness, or eco-friendly living.