6 Take Home Points from the 2014 Art & Science of Health Promotion Conference

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1)  It’s not ALL about ROI.

When the field of Worksite Health Promotion became popular some 40 years ago there were no studies claiming ROI for investment in employee health.  Leading companies decided to invest in wellness programs because it was the right thing to do.  It only makes sense, right?  Healthy employees are better employees.  They are productive, happier, less stressed, less absent and, of course, they cost less.

Somewhere along the line companies started showing a positive ROI for health promotion programs.  Yes, it makes sense if employees are healthier they will cost less.  And yes, there are hundreds of studies to prove this point.  Lately, however, there have been some reports claiming that there is actually no ROI associated with wellness programs.

For one, that simply isn’t true.  Those of us in the field know that well-designed programs achieve great financial ROI.  But that simply isn’t the point and it’s not the only reason we should be investing in employee health.  In the rest of the world, where often times paying for health insurance isn’t a responsibility of the company but rather the government, wellness programs still exists. Why? Because of all the other value associated with having a wellness program: recruitment, retention, productivity, reduced absenteeism, and morale to name a few.

A new term came up several times at the conference and I think it may stick.  VOI: Value on Investment.  I can’t think of a better value on investment than improved health.

2)  Less finger pricks, more purpose.  

Dr. Victor Strecher delivered a powerfully motivating opening keynote focusing on finding one’s purpose in life.  It was quite refreshing to hear a well known industry researcher take a step back from the numbers and focus on individuals.  This is a field, after all, that focuses on improving the lives of people.  And the research tells us that there are three things that, more than any other factors, lead to behavior change: autonomy, mastery, and purpose.  Autonomy: the feeling of being self-directed.  Mastery: the feeling of self-efficacy.  Purpose: the feeling of living a meaningful life.

As it turns out, people feeling a sense of purpose is fairly important.  Does your organization focus on allowing employees to feel a sense of purpose?  Does your wellness program address these needs?  Health Risk Assessments and Biometric screenings may seem important, but so is an individual feeling like they have a sense of purpose.

3)  Incentives do not work.

The secret is out: incentives don’t work.  At least not in producing long-term behavior change, which is often times what they are used for as part of wellness programs.  If you pay someone $100 to fill out an HRA, are they likely to comply? Sure.  Will they show up to a weight loss class?  Maybe.  Will they lose weight and keep it off?  No.

The research is very clear on this subject.  For simple tasks (filling out a quick survey) incentives are great, they work quite well actually.  One problem in this scenario, however, is the underlying message you are sending is that “this is not something you should want to do on your own volition and that is why I am bribing you to do it.”  When goals become more complex (and changing one’s behavior towards a healthier lifestyle is very, very complex) incentives, at best, will not improve your chances and, at worst, make them worse.  That’s right, incentives for long term behavior change do not work, and it’s well documented.  This was echoed by expert after expert at the conference and I’m not sure why incentives are still so pervasive throughout health promotion programs.

4)  Culture is key.

If incentives don’t change behavior, what does?  Well, the term “culture of health” has been thrown around quite a bit for several years but that doesn’t mean anyone actually has a clue what that means or what it looks like.  One thing that was repeated many times over the week was that it’s not even worth trying to change behavior if you don’t have a healthy, supportive environment.  I’m not prepared to take it that far, although, I do agree culture is a very important component to a successful wellness program.  Can you really provide nutrition education and allow employees access to unhealthy vending machine and cafeteria options at the same time?  It’s certainly worth a long look at whether or not your organization’s culture is supporting healthy choices.

5)  The more things change, the more they stay the same.

We would like to think that wellness programs have evolved quite a bit over the years.  But we heard from many experts who have been in the field for a long time that they largely remain the same, at least in their format.  Generally, an organization starts with all its employees (let’s say 1000).  They assess those employees in some manner.   Maybe half of them complete the assessment so we are down to 500 now.  Then we target the highest risk employees with interventions thinking that they are driving the cost (maybe 20% of the 500, or 100 employees).  Of those 100 employees maybe half of them will take part in the interventions we are offering and before we know it we have engaged 50 employees out of 1000.

Sure the assessments and interventions have changed over time, but this model really has not.  And it’s about time it does.

6)  The future is bright.

This field is full of bright minds and great companies really looking to improve health.  There is no shortage of truly passionate people in the field and the conference saw its largest attendance in history this year.

Dr. Don Powell and his 35+ years of experience weighed in on the topic “Future Trends in Health Promotion” and he presented some thought-provoking ideas.

To highlight a few:

1)      HRA’s and screenings will decline.   We should be doing wellness with our employees, not to them.  Additionally, we already know the risk factors of a population before we assess them.  The data is readily available.

2)      More emphasis on stress management.  Most employees report that they experience increased levels of stress in their lives and the most common source is work.  In order for organizations to successfully manage health, they must manage stress.

3)      Personalized Self Care.  Self care programs will become tailored in the way that other health programs have.  When you enter symptoms into a program that software will have your family history and health record to help draw conclusions.

4)      “Fit for Hire” certificates.  There will be a governing body to award and monitor health status across employers.  If you were deemed “fit” at your former job you can use that status to help gain employment at a new company.

5)      Wellness will become Well-being. The focus of well-being will become more holistic include physical, emotional, social, spiritual, and financial health.

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