Business of Well-being


In the first installment of this series ("10 Reasons Why Your Corporate Wellness Program Lacks Participation," Corporate Wellness Magazine Feb 2012), I discussed 10 ways to drive more people to join your wellness program. This is all part of a framework called "The 4 Rs" that can be used as a guide for designing and implementing your wellness program.

Now we turn our attention to the second R: RETENTION. Now that you have them in the door, the challenge begins! How do you keep them engaged? In part 2 of this four part series, I will discuss some of the secrets for getting real, long-term behavior change from your program participants.

It is common knowledge that you must do the obvious things to make your wellness program succeed: You need top-level leadership support, and you need to communicate to your employees multiple times (and through multiple channels) to raise awareness. Everyone knows these rules of wellness.

I want to focus on a few unconventional rules that you can use to give your wellness campaign a greater chance of success! In the first installment in this series, I talked about a model called "The 4 Rs." They are (and in this order):

  • Reach
  • Retention
  • Results
  • ROI

In that first article, I outlined 10 tools to include in your wellness program that would help drive your employees to sign up. As we transition our discussion from Reach (hopefully you have successfully created a stir and attracted many employees into your wellness program) to Retention, it is essential that you continue to take advantage of those 10 tools. In particular, four are so fundamental to success that they merit deeper discussion.

1.Incentives for performance, not participation

A decade ago, we used incentives to get people to fill out lengthy HRAs. This led to a lot of data collection and employees "going through the motions" to earn some wellness dollars. No real behavior change was taking place. Most CFOs cannot keep funding this type of approach. With the challenging economic business climate, you need to direct your increasingly scarce incentive dollars at outcomes.

Reward employees who demonstrate that they are losing weight. Pay people who come back every 3 months and perform a screening that demonstrates they are on the right track. I have seen this work in corporate settings, and I am even more convinced based on the response we are seeing using this same model in a community wellness program.

As an example, has attracted 30,000 residents of Colorado to venture out to libraries, rec centers and even furniture stores to weigh in on a fleet of automated kiosks and track their weight. All of this in just 24 months. The spark that is getting people to trek out to their local library to weigh in is the idea of being paid for changing their health.

2.Long term expectations

So you are rewarding for performance, not just participation. Great! Now you have to marry that idea with a long time horizon. You have to replace the short-term "Biggest Loser" thinking with a more realistic expectation that sustained results require sustained effort. This ties directly into solving the retention riddle. It is best to assume that your population is expecting quick and easy results. It is your job to convince them otherwise.

Instead, convince them that they need to look at this as at least a yearlong journey (and hopefully longer). I say "subtly" because you need to walk the line between giving them a realistic picture of the commitment to change they need to make, and being so successful that you deter them from even trying. Video testimonials are a great secret weapon for this. More on that in a moment.

3. Push, not pull You are busy

Your employees are busy. Everyone is busy. To make matters worse, they are distracted. Facebook Likes, text messages, Tweets and the latest Pins on Pinterest all conspire to snatch your employees' attention. Just assume that your audience will forget everything you tell them in a kickoff meeting, handout or even that great online health portal you have given them. That is OK.

We can fight fire with fire. Push your behavior change messages out through the very channels your employees are already using! Break your healthy eating messaging into bite sized (could not resist the pun) chunks that you can push out via a text message. And do it at the right time!

Let your employee tell you "I eat lunch at 11:45, so please remind me how to pick the proper portion at that time." The good news is that when we survey wellness program participants (drop me a line at if you would like a copy of the latest survey results) about mobile and social media in wellness, the majority tells us they want nutrition and exercise assistance through these channels!

4. Don't use medical scare tactics

It is unfortunate that the threat of dying from a preventable disease is not enough to motivate most people. Everyone knows that too much cholesterol is bad for you. That high blood pressure can wreak havoc on your health. That a bulging waistline takes years off your life. However, 67 out of every 100 people in the U.S. are overweight.

Even our kids are following our example. That does not mean we cannot get people to change their behavior. It just means that we need to look for a different message. The answer is item one on this list: Incentives. However, not just any old incentives. Nutrition and exercise are at the root of just about every chronic health condition.

Coincidentally the number one New Year's resolution each year is "to lose weight." Start there. A wellness program poster that proclaims, "Get paid to lose weight" will resonate much louder than "Get paid to lower your cholesterol." Guess what?

If you get someone to eat better, move more, and show sustained improvement in their weight for an extended period of time (see item 2 above), you will also see an improvement in many health metrics. You just used a more effective spark to get your employees to engage.

So let us assume that you are 6 months into a yearlong wellness initiative (and hopefully this is the first year of an even longer-range plan). You have designed your program from the beginning to reward performance. You have convinced your employees that this is a slow and steady journey. You are communicating in small doses, through the channels each employee prefers. What is next?

5. Social Proof & Testimonials

This is the fun part! By now, you should have some real outcomes to share. As your employees have been on this path to better health for half a year, some will start to experience a real transformation. Seek them out! When you are surveying your employees on how you can continue to improve your wellness offering (you are surveying your employees, right?), put out a request for volunteers to share their results.

You may be surprised by how many people are inspired to share their story. Take the top three most enthusiastic employees and send them a $50 flip cam along with three questions to answer, and a postage paid envelope to return the camera. Here is an example of what I am talking about

This type of testimonial -- in the employee's own words -- can be very powerful when it comes to getting your employees' attention and retaining them in your program. When they see someone else getting real results, it can be infectious. Total cost to do this. A few hundred dollars in cameras and postage, and a bit of editing time.

In addition, do not forget to get a release from each testimonial telling them how you will use the finished product. Remember the earlier point about the importance of executive support? If you are lucky, maybe you can get one of the more camera friendly execs to do a video. That just might go viral across your whole company!

6. Gamification and Making Wellness Entertaining

Another trend to capitalize on is "gamification." According to one definition: "Gamification is the use of game thinking and game mechanics in a non-game context in order to engage users and solve problems. Gamification is used in applications and processes to improve user engagement, Return on Investment, data quality, timeliness, and learning."

This is one way to make wellness a form of entertainment. It goes back to the point about our increasingly busy, distracted way of life. If you can incorporate fun and entertaining features into your wellness efforts, you will have an easier time getting (and keeping) your employees' attention. So how do you go about "gamifying" your wellness platform?

There are many possibilities. For instance, team challenges tied to group weight loss (make sure you are tracking authenticated outcomes using either a periodic screening or an automated kiosk). Use a real-time visual leader board showing the percent improvement of each team (just showing aggregate results, of course!).

If you can hook this into automated technology like a wellness kiosk, you can let your employees track progress (and thus stay engaged) much more frequently than if they have to wait for the nurse to conduct a screening. More frequent involvement means that your program is more top-of-mind. That is retention!

Another emerging technology approach is to use a smart activity tracker, or wearable. I am not talking about your old clunky pedometer. Look at devices like the Fitbit (my favorite), the Nike Fuel Band or the Jawbone Up Band. These devices can track actual activity levels real-time and wirelessly transmit the results to feed into personal and team-based incentive contests.

In some of the programs, we have been running for employers we are paying incentives for both measurable BMI improvements on kiosks, as well as activity incentives as measured by the Fitbit. Average 5,000 steps a day for 3 months and earn $20. Average 10,000 steps a day and earn $40.

Do this for several consecutive quarters and employees can earn back the cost of the device (typically $60 to $100). Therefore, there is no single answer to the question of "How do I improve retention in my wellness program?"

But if you take advantage of some unconventional thinking in your initial program design, and exploit some of the same tactics that make social media and gaming so captivating, you can win some of the precious attention needed to get your employees to think about health more than just once a year when they're filling out a health risk assessment.

In part 3 of this series, we will dive into the topics of measuring wellness results, exploring big data, and how to use technology to move beyond relying on self-reported outcomes. Stay tuned!

About The Author

Todd McGuire is the co-founder and CTO of incentaHEALTH. In this role, Todd has helped design and implement winning wellness programs across worksites and communities in the U.S., U.K., Singapore and Puerto Rico.

His most recent project involves getting 36,000 residents of Colorado to participate in to earn incentives for losing weight. He can be reached at

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