Workplace health programs need to be refocused, not removed

change, transform

change, transform

The latest volley against employee well-being programs comes in the form of a recently published study on a three-year randomized controlled trial of BJ’s Wholesale Club. Even though participants in the corporation’s workplace well-being offerings self-reported better health behaviors, there were no significant associated changes in employee health outcomes or healthcare spending.

Well-being program detractors have been quick to wield this study as evidence that dollars invested in workplace health programs don’t deliver commensurate returns in employee health. While there are certainly valuable takeaways, this research does not serve as an effective argument that corporate America should do away with employee well-being programs. After all, using training modules and gift cards has never compelled a lot of participation or engagement from employees – as evidenced by the 28% participation rate in the study. I don’t disagree with the premise that tote bags and online lectures aren’t strong motivators, but we can’t extrapolate that to all corporate programs are unable to positively influence employee health.

An unfair attack on employees’ potential for change

Viewing this study as evidence to reduce corporate America’s role in health is deeply damaging. It’s the equivalent of putting a band-aid on a serious injury, then condemning all trauma treatments as ineffective. Ultimately, the design and focus of well-being programs needs to change. It shouldn’t be about getting employees to adopt health practices in the short term, but creating sustainable change in someone’s life trajectory over the long term.

The suggestion that any company-run program won’t be helpful implies that behavior change can’t lead to positive health impacts. We know that post-acute care release programs for cardiac surgery work, psychotherapy works, and support therapy for addiction works – why would corporate sponsorship of a similar program prevent healthy behavior changes from happening? To accept the premise that behavior change in employees can’t be accomplished by well-being programs, is to call in to question the capacity for employees to change.

An appropriate response to this study is to recognize that traditional one-size-fits-all approaches to employee well-being don’t go far enough or aren’t structured properly. At a minimum, companies need to be judicious in how they select and implement well-being programs, and demand that providers deliver clear evidence of positive outcomes alongside a performance and value-based business model. To be sure, employers may implement health and well-being programs for other reasons — they can be good recruitment and retention tools if employees value them — but it’s important to be clear-eyed about the actual impact.

Individualized coaching the key to success

What the researchers get right is that any attempts at a broad-brush, one-size-fits-all approach is not going to make an efficacious impact. Generally encouraging employees to develop healthier behaviors sounds intuitively like it would be helpful, but we’ve seen firsthand that it takes individualized planning and coaching to accommodate each employee. Working on a person-by-person basis is the only effective way to achieve a measurable health impact and address the soaring health care costs employers shoulder – especially from the cost burden associated with preventable lifestyle-related chronic disease.

A high degree of personalization is critical because everyone’s health risks are different. One-size-fits-all educational modules may certainly provide valid information, but they generally leave employees with little insight into how they can incorporate the new information into their own lives in a way that is most likely to be effective and sustainable.  Learning and education alone will not unlock sustainable behavior change.

That’s why individualized coaching geared towards sustained habit change is so effective. Incentives like time off to reward program signup or completion of certain milestones can help motivate short-term actions, especially if they are structured to encourage involvement over time rather than just initial enrollment. However intrinsic motivators are more important to sustained change, and coaches who are habit change experts can play a key role in helping employees stay motivated and find personal satisfaction in their step-by-step progress toward achievable goals. The human relationship component is central to maintaining engagement and accountability. Gamification and regular in-program rewards are valuable, especially for certain personality types, but an app can only go so far.

Coaches are also essential in providing ongoing monitoring, encouragement and accountability to keep participants on track and help them overcome the inevitable challenges. Intensive personalized support and guidance from a trusted coach can help employees to develop healthy habits that will last a lifetime with a proven in-year payback for employers.

Time for reassessment

The Covid-19 pandemic has led many employers to place a renewed focus on employee health and well-being, as the negative impacts of the pandemic — both direct (Covid illness and its aftereffects, grief at loss) to indirect (weight gain, rising levels stress and anxiety) — have become increasingly apparent. As companies reassess their employee benefits, they should make sure their workplace well-being programs are designed to live up to their promise.

To accomplish that, employers must move away from gimmicks and “wellness apps.” The reality is that a free month membership at the gym or an Amazon gift card, is not going to motivate people to engage in behavioral health. Well-being programs need to be structured in a way that acknowledges and addresses each employee’s unique situation and then provides support for both physical and mental health over time to help them make gradual lifestyle changes that ultimately become lifelong healthy habits.

Ultimately, corporations are footing the bill for sickness amongst the working population – paying two-thirds of employee health insurance costs – and those costs will only go up as people get sicker. Well-being programs are among the few ways companies can directly reduce health care costs while helping employees to be healthier, happier, and more productive. If corporate America sees this study and mistakenly uses it as justification for canceling well-being programs for employees, then we should be duly prepared for health care costs and disease to correspondingly skyrocket among our colleagues, friends, and family.

Photo: Madmaxer, Getty Images

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