Doing the Right Thing, Even if It Hurts Participation

Practitioners have for years been so concerned with wellness participation that we’ll do almost anything to keep the numbers climbing. Financial incentives? Yeah, that will work — until it doesn’t. Premium differential? Ooh… that’s a good idea — until it’s not. Lowering the bar on what, exactly, is “participation”? No one will figure out we’re gaming our own system — until they do.

In our never-ending quest to keep participation numbers high, we seem to have lost sight of the real goal of every wellness program on the planet: health and well-being of those we serve. Participation in your wellness programs and services may be less significant than you think, or even (gasp!) irrelevant.

The bottom line is your organization has a wellness program because management believes it’s good for business. Ideally, that belief is grounded in the notion that the investment leads to healthier, more engaged, productive employees and that’s what contributes to a stronger organization. If your program exists just because your competitors have one, you’re screwed.

With a simplified objective — healthier employees = stronger organization — practitioners can begin to put wellness program participation in perspective; if higher numbers lead to healthier employees, great. If it doesn’t, stop trying to drive up the numbers and get refocused on doing the right thing for your organization.

What We Know

• Changing health behaviors is hard. People can’t be bribed, browbeaten, or tricked into changing long-established poor health habits.
• The desire for healthy self-improvement has to come from within. You can’t do it for your organization, boss, spouse, kids, or spiritual adviser.
• Changing the work environment and tweaking the culture can contribute to success, but at the end of the day it will always come down to the individual’s choices (unless you implant a computer chip that emits an electrical shock each time they pull through a drive-thru or turn a grocery cart down the cookie aisle).
• An employee spends only 10% of their life at work (it’s true; do the math), and most of that time is actually working on what they were hired to do, not lowering their cholesterol.
• Little steps — in the absence of significant goals — don’t add up to much.
  
  

Do the Right Thing

• Strip out all the financial reward and punishment from your well-being model. It obscures the goal and impedes success. That doesn’t mean abandoning recognition, however. A pat on the back or a gracious handshake for a personal accomplishment is reinforcing and appreciated always.
• Underscore the message that health is a shared responsibility — top to bottom in your organization. The individual is responsible for day-to-day choices they make; the organization is responsible for creating a supportive environment and culture that make those personal choices easier or the default choice.
• Be honest about the commitment needed to change health behaviors. Stop patronizing your clients with little changes here and there add up. When they don’t, you lose all credibility and the chance to make a real difference in someone’s life (read Small Steps or Giant Leaps: What Works Best for Health Behavior Change).
• Get serious about supporting family well-being. For 30 years the industry has given lip service to family health, with no substantive strategy or investment. If the employee spends only 1/10 of their life at work, they’re spending 90% somewhere else — most of that at home with family. Whether your organization covers dependent healthcare is secondary to the fact that what happens at home has a far greater impact on employee well-being than anything you can do at work.
• Stop worrying about participation. If you stay focused on doing the right thing, participation will take care of itself.