Engaging Your Employees in Healthy Behavior Change

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By Jennifer Wendt, Director, Customer Strategy and Integration, JourneyWell

In today’s corporate environment, employers increasingly turn to health promotion and disease management programs to improve the health of their employees and address accelerating health care cost trends. According to research by Dr. Nico Pronk, vice president and health science officer for JourneyWell at HealthPartners (Pronk, NP. (2009) ACSM’S Worksite Health Handbook: A Guide to Building Healthy and Productive Companies. Human Kinetics, Inc.) many of these programs include incentives designed to encourage employees to become engaged in health improvement efforts. Offering a financial incentive to engage employees to change behavior is generally considered a best practice in health promotion.

The central principle to an effective incentive program is value. The recipients of the incentive must value what they expect to get in order to expend the effort. Incentives for large groups may consist of cash, discounts, gift cards, or coupons. The incentive should be proportional to the effort required to become eligible for the incentive payout, i.e., more work should get rewarded at a higher level than less work. 

Health promotion programs typically focus on long-term lifestyle changes, so incentives provided frequently over time may work well. Incentives are most effective when they are delivered immediately after the target behavior is performed. The longer the lag time between the behavior and incentive, the less certain and weaker the incentive becomes. A modest, immediate incentive is usually more valued then a larger, delayed one.

To be successful, incentives must be:

Optimizing an incentive program starts and ends with a good communication plan. Stronger communication strategies make incentives more effective in driving participation. Promotion can’t stop with a one-time message. Reminders increase participation, so they should be delivered frequently and include clear messaging about what the incentive program is, why it is important, and how it works. Because people access information in different ways and at various times, communications should also be delivered by different channels, such as emails, posters, pay stub inserts, letters, and meetings. These types of communication methods increase awareness among employees, create word of mouth, and enhance opportunities for social reinforcement of lifestyle changes.

The idea of providing an incentive linked to benefits design is potentially powerful since employees recognize this as a clear value. It can also help offset costs for the employer by shifting higher contributions to employees who are not participating in the health improvement programs, therefore paying at least in part for expenses related to the programs being implemented. Completion can be linked to benefits as a prerequisite for health insurance eligibility. A reduction in health insurance premium contributions, clinic visit co-payments, or deductibles may be offered. Incentives of this kind need to be carefully designed so they are in compliance with applicable federal and state legislation and safeguard employee confidentiality.

From a population health perspective, worksite level incentive programs can be effective. Incentive programs enhance the behavior change effects of health promotion and disease management programs. The trend for employers has been to initiate incentive plans that are linked to health care benefits design. However, most incentive programs that are delivered in today’s workforce aren’t as optimal as they could be. Even optimally designed programs will probably not be strong enough, if used alone, to maintain the health of a population. It appears that incentives are a necessary, but not sufficient, strategy for population health improvement.

Make sure the incentive is paired with something meaningful. Good programs, moderately valuable and valued rewards, and clear rules are a necessary start. Employees also need to buy into why improving their health is important in the first place. Incentives are a great way to get employees attention and to get them focused on making behavior changes they may not have considered otherwise.

For a list of Nico Pronk’s published research, or to download our latest white paper, go to journeywell.com/learn.

References:

VanWormer, J.J., Pronk, N.P. Rewarding change: Principles for implementing worksite-level incentive programs. In: Pronk, N.P., Editor. ACSM’s Worksite Health Handbook, Second Edition. A Guide to Building Healthy and Productive Companies. Human Kinetics, Champaign, IL. 2009; Chapter 28.

For more information, contact Peter Zambrano, sales executive, at 952-967-7097; peter_zambrano[at]journeywell.com