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Why Positive, Ongoing Reinforcement Changes Employee Health Behavior
Although the
concept of workplace health promotion is no longer new, it’s a
good time to reinforce the basic wellness model, according to industry
experts at Wellness: New Possibilities and Challenges.
"In the past
10 years, the concept of workplace wellness has pervaded American
life," said Dr. David S. Weed, conference speaker and staff member at
Massachusetts-based Corrigan Mental Health Center.
"We know what
constitutes an ideal health status and we’ve learned the
consequences of having a less than ideal health status," he continued.
"But when it comes to employee wellness programs, efforts to determine
employee readiness have increased in importance."
Health Behavior
Even though
the domestic workforce is better informed about the wellness benefits,
it’s important that wellness providers and employees not become
complacent about health maintenance, Weed stressed.
"Successful
and long-lasting lifestyle changes rarely occur on the first try," he
said. "It’s easy to step back from a wellness initiative that
doesn’t offer results right away, especially if you know the
program is still available, and you can do it at another time."
Changes in
health behavior require a lasting commitment, and that’s a
concept program directors and participants must remember, he added.
"On average,
people require about seven attempts before they are able to maintain a
lifestyle change for six months or more," said Weed. "Even then, most
need support over extended times to prevent a relapse to earlier
behaviors."
Promoting Change
Positive reinforcement is helpful, but rarely sufficient, in keeping employees involved in wellness programs, Weed said.
"Admonitions
about the need to change are rarely helpful," he said. "Establishing a
respectful rapport between program providers and participants is a
better approach. This helps [the participants] understand their own
goals and is much more likely to produce lasting results over time."
It’s
also important to remember that change is "not a single event, but
rather a series of steps," and that each requires different strategies,
he added.
"Contemplation,
determination, action and maintenance are wellness program
ingredients," said Weed. "Program managers have to get employees to
think about the need to change, expose them to information, get them to
talk about the issues and increase their awareness. It’s about
motivation, and the ultimate goal is to increase the likelihood of
success."
Different Stages
Although the
desire to join a wellness program often exists, employees are often not
ready to start the process, according to Weed.
"When it
comes to lifestyle changes, such as quitting smoking, starting an
exercise plan or losing weight, people often need a long period of
frequent exposure," he explained. "This is a challenge for wellness
program managers. Then they have to follow up with information about
the benefits of changing followed by practical information about how to
change."
Another challenge is assessing the employee’s stage of readiness, he added.
"Start with
where the person is," Weed said. "Explore current behavior and begin to
find the cracks. This begins to build momentum. But for those who are
considering health changes, but haven’t begun them, ask how they
view their current health status and how they see their own health
future."
Setting An Agenda
Helping employees establish a "health agenda" is a good approach for program managers, Weed noted.
"Find out
what the employee’s agenda is," he said. "[Tell them you] often
talk to people about smoking, food or exercise and ask what concerns
them the most. And don’t forget to listen and elicit their
responses."
Setting the agenda also involves determining barriers that thwart healthy changes, Weed added.
"Ask what
gets in the way of making changes," he stressed. "Reinforce any effort
toward the desired goal, but don’t forget about the continued
barriers. Imagine extremes and explore concerns."
Motivation
Wellness experts should rely on a motivational approach that "engages" an employee, Weed advised.
"Movement
from stage to stage is determined by a person’s motivation," he
said. "Motivation is an internal process, but that process can be
influenced by external factors."
Encouragement is an important component of the process, he added.
"We need to
use a style of counseling that promotes movement from one stage to the
next," Weed explained. "This is one way to increase motivation by
helping employees explore and resolve ambivalence."
However, "motivational interviewing" also requires personal expression and examination, he added.
"Acting in
more healthy ways requires that we resolve ambivalence in favor of
desired wellness behaviors," said Weed. "Motivational interviewing
permits expression of both sides of the ambivalent feelings and uses
empathy and affirmation to support a shift toward healthy choices. This
sustains a non-judgmental relationship that supports the struggle, not
the outcome."
Address: Dr. David S. Weed, Corrigan Mental Health Center, 49 Hillside St., Fall River, MA 02722; (508) 235-7200.
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