Business of Well-being

Challenging the Mainstream

I have been fortunate to observe and learn from someone who fished with a net. This very interesting and intricate process to capture as many fish as possible is not as simple as it seems. The net is not merely thrown into the water. There is planning and technique as the net is prepared to be cast.

Once ready, the fisher does not simply whip the net into the water; this, again, is a carefully choreographed maneuver taking into account wind direction and speed, water movement, and position of the school of fish sought. Once lofted into the air allowing the wind to open the net to its fullest volume, the net collapses down into the water, and over the school of fish.

With yet another move of agility and planning, the fisher not only draws the net back to the boat with some fish, but does so such that the net folds under itself setting a sort of cup-like trap for fish. The catch is then quickly drawn by the net onto the boat.

Regardless of the number of fish captured, this process does not stop, but is repeated on each side of the boat, moving around with the school of fish until either the catch total has been reached for the day or the fisher is called home.

Wellness by 'Net'

The analogy translates rather well when I think about wellness in the workplace. We, who deliver wellness programming to our employees/colleagues, can take a lesson from the net fisher. Wellness, like the net, needs to be a carefully choreographed set of programs "thrown" or "tossed" out to the employee population with consistency and repetition despite the number of "fish" that may latch on.

Herein lays the first challenge with wellness programming to date: we give up the moment engagement drops. We need to do the opposite and keep providing, la "casting the net." Under Prochaska's model "Transtheoretical Model of Behavior Change," the very core identifies that behavior change is a combination of desire - her on part of the employee -- and the need to maintain alternative behaviors to sustain change.

So, not unlike the fisher and the net, wellness programs cannot simply stop out of frustration or lack of participation. Instead, they must sustain their presence and provide the "net" for employees when they are at their moment of behavior change. To continue the comparison, the preparation and communication of wellness programming is equally important.

Just like the fisher who carefully gathers and folds the net prior to casting, we need to prepare the programs. A hastily or overly complicated rollout can destroy both program and integrity of the entire wellness initiative. Complex and difficult-to-access programs turn off users.

As we step back and evaluate the programs we offer, be mindful that redesign may be necessary, but can confuse employees when there is not clear communication about the changes and methodology. In summary, remember to:

  • Prepare your net with care
  • Cast your net wide, often, and consistently
  • Don't stop casting your net
  • Repeat steps 1-3.

A Culture of Wellness and Chasing ROI

Use the word "wellness" for what it truly represents and believe in what it stands for. To "be well" or to have a "wellness culture" are terms that are similar to "diversity" or "empowerment." But, is wellness or building a culture of wellness just another buzzword to feel good about something done toward health?

Or is it an achievable, measurable, all-consuming cultural phenomenon or goal? To call wellness a cultural phenomenon/goal is to camp with millions of people and companies around the world. Estimates for the United States are somewhere north of $160 billion. Yes, and this is based on a study using 2004 data.

Surely that spending has risen significantly since then. A 2010 Society of Human Resource Management survey estimated the spending to be around 2 percent of healthcare claim costs. With 91 percent of companies offering some type of wellness program, the math points toward an overwhelming belief that we employers believe we can affect health and healthcare costs if we build a wellness culture.

So, we're not alone if we believe in "wellness." Good. But does it really work? Can there be a return on that 2 percent +/- investment (ROI)? Many wellness program providers respond, "YES!" But, bundled in that answer are huge holes that exist in the methodology and measurement toward the ROI. The calculation has:

  • Hard-dollar savings
  • Cost avoidance
  • Presenteeism or engagement improvement
  • Lowering of absenteeism

Two of these measures are "hard" savings or directly impact on the claims cost (hard-dollar savings and cost avoidance), and two are more soft measures (presenteeism/ engagement improvement, and absenteeism impact). The fact is true ROI in wellness can take up to 3-5 years.

The statement "building a culture of wellness" does not seem too far off considering this time horizon. The reality is that ROI is really trying to predict what might NOT happen if someone became or stayed well - a crystal ball. What we do know is that disease and unhealthy behavior cost health plans money.

Avoiding or limiting those risks is the best way to move the ball. The truth is, like so much around behavior change, developing a wellness culture takes time, patience and belief that the programs that are being offered are designed to help. Whether a company throws money at wellness in incentives or chooses to add penalties and access limits to de-incent, there is an intrinsic understanding that we can move employees to change in time.

For years, I have used the analogy discussed earlier. When the net is cast wide and often, that particular catch will be plentiful. But, if the net is only cast once and not very wide, the catch will be limited, if not nonexistent. Like the fisherman, wellness programs need to be cast wide and repeated as many times as possible.

This "catches" those who are at a particular point in their behavior change to engage. Repeated engagement brings about change in time. According to the U.S. Centers for Disease Control and Prevention, a smoker will permanently quit only after 6-9 attempts. In other words, we have our work cut out for us!

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