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Stress Management

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."


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.

© 2004 Health Resources Publishing