The Four Things I Know For Sure

The statistics are daunting -- with failure the norm -- but employers should still strive to help their workers live healthier lives. And incorporating emotion and fun into the mix are big parts of it.

When writers start out, some mentors encourage them to "write what you know." Others suggest that what writers know may bore them and, in turn, bore their readers. Instead, these advisers suggest writing about what interests the author deeply with the hope that "your readers will catch fire at your words."

At the risk of boring you with what I care about deeply, what follows are four things I know for sure about changing human behavior.

For me, behavior change comes down to some basic observations: Facts don't change behavior; you have to make it personal; just because you show up, it doesn't mean you're committed; and you need to bend your knees, lean forward and enjoy the ride.

I use health examples to describe these points, but could easily use retirement planning or getting your children to make their beds as illustrations.

Let's start with facts.

According to the National Institutes of Health, you will gain weight this year between Thanksgiving and New Year's Eve. The good news is you'll only gain a little more than a pound if you're reasonably normal-weighted. The bad news is you'll never lose it.

Throughout the year, you'll add another half pound and enter the 2012 holiday season almost two pounds heavier than you are today. If you're overweight or obese, you will gain between five and 10 pounds during the holidays and you won't lose that, either.

I'm going to take a leap of faith and guess that most of you will not follow the usual holiday wellness tips, including eating raw vegetables before you go to a holiday party and sipping sparkling water with lime most of the evening.

That leads to my next observation. We have to personalize our messages.

Four studies released in March 2006 from Stanford, Northwestern and New York University revealed two aspects of successful health communication: Relate to the emotional state of the listener and focus on the consequences of an illness for the individual or the impact on their close family or friends.

I was successful -- for a period of time -- in getting a morbidly obese friend to lose weight by telling him two things. I was so concerned he was going to have a heart attack that I reviewed CPR every morning. And, secondly, I was afraid he would die prematurely, leaving his wife and three young children without a dad, and having someone else walk his daughter down the aisle on her wedding day.

Too personal? Perhaps. But it got his attention because the message touched his emotions.

Once we decide we're going to take action, however, we have to deal with sustainability. Just because we show up, it doesn't mean we're committed.

According to the National Center for Health Statistics, every year about seven Americans per 1,000 will marry while four to five per 1,000 will file for divorce. Despite the divorce risk, 2.3 million of us will walk down the aisle this year.

It's not much different with our behaviors. Seventy percent of smokers will attempt to quit in any given year, but 80 percent will start smoking again in 12 months. Two-thirds of dieters will regain the weight they lost within a year and 98 percent will be back to where they started within five years.

We love and hate taking risks. But we're also as afraid of being successful as we are of failure.

Peter Sandman, a risk-communications consultant, indicates that when we fall short of making permanent lifestyle changes, we take comfort in the prevalence of our condition in those around us. We believe, if we really wanted to do it, we could change our behaviors and reduce our risk of imminent death and disability.

Our defense becomes, "We just don't want to do it."

This leads to my final observation. We need to bend our knees, lean forward and enjoy the ride. Quite simply -- we need to have some fun.

And we haven't done a very good job of incorporating fun into most of our behavior-change programs.

The University of Michigan's Dee Edington found that lifestyle risks travel in four major clusters. One of these clusters is psychological risk. Nearly half of employees who fit the psychological risk profile (described as poor self-perceived health, low life satisfaction, high stress and greater than six illness days a year) are high health-risk individuals, with five or more risk factors.

Edington's research indicates that high healthcare and disability costs are associated with the total number of employee risk factors. If your employees aren't happy, your bottom-line expenses are probably showing it.

What can we do with these observations? Here's what I've learned.

* Place less emphasis on facts and more on personalizing programs to the individual. What inspires me may not capture you.

* Prepare people for failure as much as for success. Early in my career, when I was treating clients, we would develop a strategy for when the client fell off the plan -- we created a re-entry scheme that had no penalties.

* Make any behavior-change program enjoyable -- fun, if possible.

And, again, it should be the employee's version of fun, not yours.

So, those are the things I know for sure. With any luck, I didn't bore you and, perhaps, I sparked your vision of how to help employees consider change.


Carol Harnett is a widely respected consultant, speaker, writer and trendspotter in the fields of employee benefits, health and productivity management, health and performance innovation, and value-based health. Follow her on Twitter via @carolharnett and on her video blog, The Work.Love.Play.Daily.

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Oct 24, 2011
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