Fitter, happier, more productive

There is a wide range of products to help employers incentivise behavioural change in the lifestyles of employees. Sam Barrett finds they only work as part of an integrated approach to workplace health.

The latest employee benefits promise a new improved workforce. Employees, the providers claim, will be happier, healthier and more productive. But, with these tools often provided free with other benefits or costing a matter of a few pounds per person, can they really deliver all that they promise?

A variety of employee benefit tools are available that claim to encourage employees to change their lifestyles. Health promotions, gym memberships and wellness days can give employees the incentives they need to make changes to their health.

Wellness days can be cheap and straightforward to arrange, with many wellbeing benefit providers happy to come along or provide material related to these events. But although they can be well supported, their effectiveness at changing behaviour is questionable. Professor Mike O’Donnell, chief medical officer at Unum, says: “If you want these events to work then they have to be as interactive as possible.”

As an example he points to London Underground, which has been running a series of health and wellbeing fairs for its employees. “They use interactive tests and health advisers who employees can chat to about health issues. It’s difficult to measure whether there are any improvements but employees do engage with it and the positive feelings this creates towards the employer can be beneficial,” Professor O’Donnell adds.

It is also important to make these promotions as visible as possible. Joyce Roberts, head of integrated healthcare strategy at Axa Icas, says that as well as the distribution of standard promotional material, peer pressure can improve take-up.

“Word of mouth is the biggest driver for change so a company can get certain employees to be champions and tell others about their successes,” she explains. “You can also make events fun. For example we had a challenge to walk the equivalent of Hadrian’s Wall using pedometers and this really took off with people who wouldn’t normally take exercise getting out at lunchtime to do their bit.”

Using different types of communication will also increase the success of these programmes. “Employees respond to different forms of messaging so don’t rely on just one form, such as online information, to change employees’ behaviour,” adds Roberts. “It also has to be relevant to the employee and their life stage. Twenty year olds think they’re immortal but older employees are more likely to respond to messages about improving the quality of their life in later years.”

She also recommends being as creative as possible with messaging. As an example she suggests putting a poster in the lift telling employees about the number of calories they’d burn by taking the stairs.

Another common tool that has become fashionable in the last couple of years is the online health assessment. These quiz the employee about their health and lifestyle, using the answers to provide them with personalised feedback and advice on how they can make improvements.

These assessments can be provided on a standalone basis or are increasingly included with other products. For example Bupa and Norwich Union include one with their medical insurance. “We offer 14 different online tools,” says Tony Urwin, general manager of Bupa Psychological Services. “Although they won’t be effective with every employee, the beauty of them is that they can get to lots of employees quickly and easily.”

As far as their ability to change behaviour goes, Cary Cooper, professor of organisational psychology and health at Lancaster University Management School, says these assessments can be effective providing they are structured correctly. He explains: “These assessments are good but they need to tell employees what’s causing the problem and what they can do to improve things. For example, it’s pointless telling an employee they’re stressed, if the service doesn’t pinpoint the fact that their time management is an issue and suggest ways they can address this.”

There is also a danger with these online assessments that they become a bit boring. “It’s easy to devise a questionnaire that asks people about health-related matters such as how much fruit they eat and whether they take any exercise,” says Professor O’Donnell. “The trouble is this isn’t very stimulating and it’s unlikely to lead to behavioural change. Any type of activity has to engage the employee if it’s going to succeed.”

Health screening, whether a full-blown executive style programme or bringing a nurse onsite to check everyone’s cholesterol or blood pressure can be the catalyst for change too. Again though, it is important to follow it up with relevant information and advice. “If you saw your GP and they diagnosed you with diabetes you’d want to know why this had happened and the options you had to manage it,” says Professor Cooper, “so make sure you do the same with any screening programme.”

As well as providing employees with information, incentives can help to encourage change among employees. Cooper explains: “An incentivised scheme works better than a punitive one,” he explains. “For example, when Royal Mail offered its employees entry into a prize draw with prizes of cars and holidays if they attended every day, absence levels fell.”

He also recommends asking employees what incentives they’d like. “They’ll come up with some interesting things, which won’t necessarily be expensive or difficult to offer,” he explains. Examples include extra holidays, longer lunches and gym membership.

Online reward and motivation programmes can also be used to reinforce behavioural changes. Richard Doig, regional director for compensation and benefits at Heath Lambert, explains: “These programmes are very wide now, covering all sorts of products so you could target them to health related benefits. For example if someone cycles into work, give them some points to spend on health and leisure products. This will help to change the culture of the workplace.”

Change also requires buy-in from the top levels of management. “If you don’t have management buy-in, any initiative will be like rising damp,” says Roberts. “It’ll work at the bottom but take-up will eventually stop. People role model on their superiors so if they see positive changes from management they’ll be more likely to do the same.”

Experts also recommend focusing on the positive side of any health improvement programmes. “People tend to focus on the negative side when talking about workplace health, for example whether employees are stressed,” says Urwin. “But these programmes can be much more effective if they concentrate on the positives such as job satisfaction, good relationships with colleagues, feeling valued and so on.”

To encourage this he suggests running some health initiatives on a team basis. “Get teams of five or so employees together and send them out for a walk with pedometers at lunchtime. They don’t have to work together but they’ll learn about other parts of the company and this bonding will lead to new ideas within the workplace and a greater sense of belonging.”

So, while the latest products may promise a host of benefits resulting from the improved health of the workforce, employers really need to make sure they have the right culture in place first. Without this, lifestyle improvements will run into sand.

Focus – The health belief model

The health belief model is a psychological model that can be used to predict health behaviours. “This model can be used as the basis of all sorts of change programmes,” says Max Tookey [left], senior lecturer in organisational behaviour and health at work at the University of Greenwich. “It’s commonly used to increase the effectiveness of smoking cessation programmes for example or to help change behaviour in people who are sick.” The six stages of the model are:

  • Perceived susceptibility

    This defines the population that is at risk, for example, if the company wants to run a well-being programme then all employees could be the population as they could all benefit.

  • Consequences

    This details the risk and what could happen if there is no intervention. For example, the risk of not running a well-being programme might be poor health, higher sickness absence and reduced productivity.

  • Perceived benefits

    This emphasises the benefits of following the programme, for instance better health and a longer life, and will encourage employees to take part.

  • Barriers

    These are things that could stop the programme being effective. As an example, if a company launches a marathon training programme, few non-runners will feel able to join in.

  • Cues to action

    This covers all the promotional activity around the programme. This could include an online health assessment programme,

    which could flag up the well-being programme as well as posters and emails.

  • Self-efficacy

    The final stage relates to providing the necessary training to undertake the action, which could be the programme itself.

    As well as helping to target a programme, Tookey says the health belief model can also be an essential part of change. “In change management, if you want to initiate change then you need change agency skills,” he explains.

    “Awareness of the health belief model is such a skill and it will help make change more effective.”