Nudging Your Way to Effective Employee Wellness Initiatives

U.S. employers are spending big money on wellness as part of a multifaceted effort to suppress healthcare costs. Employers both large and small have instituted strategies concurrently to propel their workers to better health in the hopes of cutting costs.


Larger employers often purchase coverage for their populations through group plans that avail expansive networks and resources to subscribers. These plans are more cost effective since generally more members are covered. Smaller employers often self-insure, meaning they wholly cover subscriber claims usually serving as the impetus for the creation and implementation of wellness programs.


However, many wellness programs miss the mark by failing to get the at-risk populations within their crosshairs. The carrot approach loses its luster and utility over time. The magnetic pull of monetized incentives is dulled beyond a few hundred dollars. Evidently, the stick approach fails too, since it disengages employees with the ever-looming threat of facing penalization.


And both approaches expose the obvious: cost driven compliance that forever taints the perceptions one holds of their organization. Luckily, there is another way you can cultivate a healthy workplace - one that plays on our subconscious and never preys on our wallets.


In spite of what the media or your cubicle residing HR professional has led you to believe, most people intimately care about their health, but many do not know how to go about improving it. Nor do employers.The effectiveness of wellness efforts only extends so far if they only include screening, activities, or education.

Some reach a bit further as they incorporate physical activity programming, avail space, dedicate money to fitness activities, and deploy health coaches and ergonomists to rove the floors of factories and offices to coach people. While these initiatives are well intentioned, they require immense individual effort yet yield little impact on health.


The most effective and least labor-intensive efforts are those that influence lifestyle behaviors through default decision-making - something best achieved by creating a supportive environment. An environment conducive to healthy behaviors can be harvested by nudging. No, not nudging in the literal sense, though we humans sometimes need some encouragement in the form of a friendly prod to take action (asking someone on a date, applying for a job, or taking the lead role in a play).


Nudging in this case - as illustrated by Thaler and Sunstein in their seminal work, Nudge (2003) - is choice architecture that alters people's behavior in a predictable way to achieve the desired outcome. Nudging creates a default for people by playing on their subconscious system by winnowing down or outright eliminating options, which in turn, prompts healthier behavior.


Some examples include health messaging and advertising to portray unhealthy behaviors such as smoking and poor nutrition as a means to discourage people from engaging in them within or in close proximity to the workplace.


Streamline dining and vending options, or outright overhaul them, to include only foods and snacks that are low calorie, low fat, and low sodium. Additionally, where food and beverages are displayed (eye level or near checkout) also influences better choices.


Furthermore, as it relates to physical activity, stairwells and walking paths can be clearly demarcated within the workplace. Biking or walking trails/paths can be highlighted. And for workplaces with nearby public transportation, imposing restrictions or banning on-site parking could help influence active commuting.


While nudging is not a foolproof measure, it can be more "fail proof" than participation or penalty drove strategies since it aligns constituents with a path to improved behavior. While drawbacks to this measure do exist as presented by Smith and colleagues (2013), they can be stymied if portrayed and availed as voluntary or rational and of course, without harsh repercussions.


A decision on what is best should ultimately and collectively be determined by the employer, regulatory bodies if applicable, and jurisdiction while accounting for the organization's existing culture.

References

  1. Smith, N.C., Goldstein, D.G., & Johnson, E.J. (2013). Choice without awareness: Ethical and policy implications of defaults. Journal of Public Policy and Marketing, 32, 159-172.
  2. Thaler, R.H. & Sunstein, C.R. (2008). Nudge: Improving decisions about health, wealth, and happiness. New Haven, Connecticut: Yale University Press.
  3. Tringali, V. (2016) Improve Company Health and Bottom-Line with Targeted Approaches. Corporate Wellness Magazine, May 2016.