Making employee wellness a less bitter pill

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"Take good care, others depend on you" Lee

Background
The benefits of investment in employee wellness have been reported for both employers and employees in the form of improved health, productivity, morale and in cost savings. Whilst individuals are responsible for their own health in terms of their level of physical activity, the food choices they make and the ways in which they deal with workplace stress, employers have a corporate responsibility for putting systems into place that inform and facilitate employees to make healthy choices at work.

Employee lifestyle choices impact heavily on the overall health and wellbeing of the workforce with obvious consequences for sickness absences, recruitment and retention of staff and job satisfaction. The case for workplace wellness initiatives is therefore irrefutably based in common sense.

However, whilst there is a strong case for the development of workplace wellness schemes, published data on effectiveness is limited as many have reported low participation rates. It is suggested that only the healthiest employees tend to participate in such programmes and is argued that previous workplace fitness programmes may have suffered from poor attendance because the activities provided do not meet the workers’ needs.

The formulation of successful initiatives needs, therefore, to be tailored to the individual needs of the population and implemented and communicated effectively as an employee benefit to fully engage employees rather than to affront staff by ‘dictating’ to them about behaviours they consider to be irrelevant to their working lives.

Approaches to wellness
The complexity of changing health behaviours, as opposed to selling a tangible product, means that social marketing has been shown to provide a very promising framework for improving health both at the individual level and at wider environmental and policy levels. It combines commercial marketing strategies, with theory-based conceptual models to develop effective campaigns and interventions to affect health behaviours and lifestyles. ‘Selling’ an intangible, and potentially negatively regarded concept, such as taking regular exercise, can be considered more complex than selling a tangible product, such as a soft drink, and therefore requires a complex approach to reframe the ‘customers’ perception of the ‘product’ before an intention to participate (‘buy’) can be achieved.

Previous research has found that traditional health promotion messages that frame health behaviours as ‘positive’ and ‘healthy’ have been received very differently by some audiences than intended by health promoters.

In order to affect behaviour change amongst employees, the exact nature of that groups’ attitudes, social influences, knowledge and so on needs to be understood in order to re-frame the health promotion message to have relevance to that population. Programmes that do not effectively aid reframing have been shown to be less likely to succeed. To illustrate this, a case study example is presented of a workplace wellness scheme set in an acute NHS hospital, where particular target groups (e.g. ward nurses) were very difficult to reach with traditional health promotion messages.

Case study
Despite great success with certain occupational groups (e.g. administrative staff and some medical staff), our workplace wellness programme had failed to reach the largest NHS staff groups, namely domestic assistants and nursing staff. Our research highlighted that these groups were often inactive, consumed a poor diet, and exhibited a culture of being stressed, not having time to exercise, eat healthily and take breaks.

This suggested that change needed to take place at a cultural level amongst nursing and domestic staff before any increases would be seen in the number of staff taking part in specific health behaviours. Our challenge was to help staff make these connections and find ways to begin the process of change.

We also found that that the usual health promotion approaches were not effective in reaching the priority groups. For these staff, our campaign needed to move away from individual benefits and instead to highlight the benefits of individual health behaviours for the good of the family and others in general.

We also found that the culture of NHS staff, particularly nurses, is one of caring. They tend to be caregivers both at work and home, therefore the traditional messages of exercise and other health behaviours being fun, making you feel better, look better and so on, were irrelevant to individuals for whom life revolved around prioritising others, looking after their patients, families and other dependents.

We carried out research that informed the design of Social Marketing campaigns that reframed the health messages away from health behaviours being the selfish option, towards them being sociable and that healthy caregivers/staff/family members make better carers/employees/role models.

Employee Engagement Summit
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The strapline that underpinned the campaign was: “Take good care, others depend on you”. This was designed to reframe health behaviours away from being selfish and using valuable spare time that should be spent on others, towards being a worthwhile investment for the good of others as well as themselves.
Studies that will demonstrate the outcome of this campaign are underway.

Conclusions
The case for workplace wellness programmes is clear and the need for them irrefutable. However, promoting health in the workplace is a difficult task. One way of increasing effectiveness is to thoroughly research staff knowledge, beliefs and attitudes using appropriate methods, rather than relying solely on quantitative data relating to current behaviours. Social Marketing campaigns may be an effective way of re-framing health behaviours as being more desirable and achievable amongst harder to reach groups.

For further information and ideas see: www.qactive.co.uk

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