Ready or Not, Here Comes...Wellness
Ready or Not, Here Comes ... Wellness | Human Resource Executive Online
To reap short- and long-term benefits of wellness initiatives, HR leaders must understand that assessing readiness for change is key to success. The best intentions do not always end in the best results.
By Colleen M. Reilly
If you are considering the implementation of a companywide wellness program, you most likely realize that you are embarking on a journey that requires a significant shift in thinking, attitude and values -- in short, it requires change.
From an organizational perspective the need for change is supported by rising healthcare costs that can be controlled and even reduced by implementing an integrated wellness program. From an individual's perspective, the need for change may be obvious or completely obscure, depending on the person's readiness level -- a highly subjective set of needs, desires, knowledge and motivation.
Taking time to implement a systematic approach to help set the stage for a major cultural and personal transformation is perhaps the most important and overlooked element in creating effective wellness programs.
The transtheoretical model, also known as readiness to change (RTC), was developed by James Prochaska, and is a widely researched and proven approach to help both individual and organizational transformation. An organization's ability to influence the voluntary lifestyle behavior of a group of people depends, in large part, on the population's readiness for change.
I have seen remarkable results when an organization creates a culture of wellness over time for long-term benefits -- but the best intentions do not always end in the best results.
Parking Lot Candy Swap
I remember a couple years ago I didn't heed my own advice and I removed all unhealthy snacks from the vending machines and replaced them with healthier options.
During a subsequent companywide meeting, the CEO was asked more questions about the vending machines than the state of the business. He passed the microphone to me, and at the end of a 20-minute debate, I told the employees that, if they wanted candy bars, they would have to bring them to work because we were not going to provide them.
The following week, I was surprised to see employees setting up candy shops and swaps in the parking lot. I quickly realized that these employees would need more time and education on the benefits of this wellness initiative before they would be ready to change their behavior.
Not wanting to make this mistake again, I was very deliberate with helping the organization become smoke free.
Understanding the culture and the general resistance to change -- of the 22 percent of employees who used tobacco, about three in four (74 percent) were in pre-contemplation or contemplation (reluctant or not ready to quit) -- so we focused on a slow, gradual transition.
Initially we started with a focused education-and-awareness campaign on the benefits of becoming smoke-free to ensure that people understood what was in it for them.
Shortly thereafter, we began action-based programs, and every six months, we offered a new program or incentive. We began with an online smoking-cessation program, then a telephonic quit-line, followed by free nicotine-reduction tablets if enrolled in the telephonic-cessation program. Subsequently, we offered 100 percent reimbursement for prescription smoking-cessation aids.
Finally, after two years of education and communication, we made the campus smoke-free and offered employees a $30 per paycheck reduction in healthcare premiums if they were smoke free or enrolled in a cessation program.
There was not one complaint. And because we took the time to move people along the stages of readiness for change, we didn't see any impromptu tobacco shops in the parking lot either.
These two examples demonstrate the importance of assessing readiness for change, not so much in determining whether your company can benefit from a wellness program -- most, if not all, companies can -- but rather to determine the type of program design and communications timeline that will work best for your population, based on their risks and their readiness to change.
The Readiness Scale
The very process of measuring your employees' readiness for change is an opportunity to communicate the short and long-term benefits of a healthier lifestyle. To get your wellness initiative off to a good start, be sure to design or adopt a "readiness meter" that can clearly determine where your employees stand along the readiness continuum.
There are many factors that influence a group's collective readiness for change when it comes to healthcare behaviors, and it is important to know what the major factors are so that you can develop a baseline for your wellness program.
Recently the Centers for Disease Control and Prevention published a study showing 50 percent of a person's health and healthcare costs is determined by their behavior while only 10 percent is based on access to care and 20 percent is based on genetics and environmental factors. This information is a critical paradigm shift for most employees -- their lifestyle choices do affect their health and their healthcare costs.
Your "readiness meter" definitely needs to assess your population's understanding of the effect of behavior on health, and how receptive each worker is to accepting and using the resources, tools and strategies your organization is willing to provide to them through an organized wellness program.
Since employers, especially self-insured companies, shoulder the majority of the healthcare costs for their populations, it makes a lot of business sense to help influence employee behavior toward a healthier lifestyle.
It is really a simple equation: If you can get your people to increase physical activity and eat more nutritiously, you can help them reduce major health risks that lead to depression, cancer, heart disease, stroke and osteoporosis.
More than 50 percent of diseases and conditions can be prevented, and oftentimes reversed, through lifestyle change. Simply communicating these facts to your employees in positive, consistent and creative ways can help create optimism.
There are five stages of readiness for change:
* Pre-contemplation: Not ready to change
When people are unaware of the need to change or can't see any benefits to changing their behavior, they simply are not ready to change. In order to move them closer to readiness, you will need to provide them with basic health information and easy-to-understand proof that there are personal and even financial rewards for changing their behavior.
* Contemplation: Thinking of changing
People in this stage of change readiness are already aware of the positive benefits they could reap from losing weight, eating better or exercising more. This group needs encouragement and concrete examples of ways they can change their behaviors step by step to gain enough confidence to easily move toward beginning the actual change process.
* Preparation: Ready to change
You might find that a large percentage of your population is already educated about the health benefits of various behaviors. Before introducing action-oriented components to your wellness program, you want the majority of your employees to be at this readiness stage. From this point, they will welcome change, they will take advantage of opportunities you present to them in your wellness program and they will begin to build the very strong foundation your organization will need for a long-term health-focused culture.
* Action: Making change
This is the stage where action is the word of the day. A well-prepared population will seize the opportunity to take part in every aspect of the wellness program you are ready to offer to them. They will participate in weight-loss programs, create teams to compete in sports events and consider consumer-driven health plans as an alternative to traditional plans. The importance of incentives becomes clear during this stage when people are already changing their lives and need to stay motivated for the long run.
* Maintenance: Changed
While this is the last stage of readiness, staying here is not guaranteed or easy. Once your organization embraces the wellness culture, there is still work to be done on a regular basis to help people stay on track. Measuring and communicating results are extremely important since people need to be reminded and reassured that their commitment to their health is one the most important things they can do for their total well-being.
Lasting Impact
When you look at the five major lifestyle-risk categories that determine one's overall well-being -- smoking, weight management, nutrition, exercise and stress -- it becomes very clear that we can make major improvements with relatively little effort.
When only 3 percent of the American population eats right, doesn't smoke, exercises most days of the week and maintains a healthy weight, there's certainly room for improvement.
The long-term benefits of an integrated wellness program include savings up to 10 percent on healthcare costs, but the short-term rewards are also remarkable: improved productivity, optimism and a culture of shared values where wellness matters.
Colleen Reilly is the president of Total Well-Being. She has worked within the corporate wellness industry for more than 10 years at Coors Brewing Co., Mayo Clinic and Nelnet Inc. Most recently, she launched
Total Well-Being
, an organization focused on helping small to mid-size organizations implement strategic wellness programs that yield results.
August 4, 2009 Copyright 2009© LRP Publications
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