Do Employees Pick Up the Wellness Programs You Throw Out There?

in Uncategorized, Employee Wellness Programs

A truck worker in a snowstorm

On a snowy winter day, as I listened on a conference call with a client, I watched through the window of my cozy home office as the curbside recycling truck lurched to a halt.

A burly guy jumped off the truck, where he’d been clinging in the blasting snow and arctic wind. In his orange reflector-striped parker, snow-dusted cap, and humongo gloves, he lifted my recycling bin out of the snow bank where it’d been half-buried by the city plow and in one swift move heaved the clinking and clanking contents into the backend of the truck.

He tossed the emptied bin onto my snow-covered driveway and stepped back onto the rear of the truck as it grinded away. With its amber caution lights flashing and sparkling in the icicles that hung off its rim like a damaged chandelier, the truck — its passenger clutching the back and ducking his head out of the wind — vanished into the whiteout.

“What kind of wellbeing program would appeal to this guy?” I thought. “What would be useful to him?”

On my conference call, the client was chatting about placing fruit-infused water stations in break rooms.

Would the recycling worker want a fitness challenge to track his steps? Would he like a health coach to call that evening to “nudge” him to eat fewer carbs? A work-life balance lunch-and-learn?

In the latest iteration of employee wellbeing, where all the buzz is about purpose, authentic self, mindfulness, and gratitude, would the recycling worker pick up what we’re throwing out there?

I don’t know what this individual worker wants and I won’t make assumptions. I haven’t spoken to him yet, but, like you, I chat with blue collar employees, manual laborers, and lower-wage workers every day. Some I meet in the course of my daily business, some are friends, some are family members. And I do ask what they want and how their workplace can support their wellbeing.

_____

The above was originally the preamble to my LinkedIn post, “How My Dad Proved Steve Jobs Wrong About Loving What You Do…”, but I cut it because of length, relevance, and tone. Still, I’d love to hear from you. How can we serve employees in job classes like this recycling worker? How can we best support their wellbeing? 

Mindfulness: For Sale By Owner

in Uncategorized, Wellbeing

lotus representing meditation and mindfulness

I’ve practiced mindfulness and meditation since 1977, and have had the good fortune to have learned from some of the greatest teachers in the world. 

In 2000, I took personal vows to commit my life to mindfulness (admittedly, I haven’t been diligent in recent years). 

In my 2003 book — now out-of-print — the longest chapter was called, “Mindfulness: The Secret to Health Change?”

 Around 2004, I founded a small mindfulness group in upstate New York that is still going strong. 

If I had final words of wisdom to offer my kids, I’d commit my last breaths to advising them to practice mindfulness.

That said, I still believe mindfulness is being oversold in the corporate and wellness worlds.

Job Crafting: Challenges, Hindrances, and Resources

in job crafting

Job crafting worksheet

Job demands cost energy and affect job stress and health. Job resources affect motivation and performance and can buffer the negative affects of demands.

All job characteristics can be thought of as either demands or resources. This is the foremost proposition of the Job Demands-Resources theory of job stress and motivation, which I described in Stay Woke About Work: Job Demands and Resources Shed Light on Stress and Motivation.

Richard Lazarus and Susan Folkman’s classic 1984 book, Stress, Appraisal, and Coping, defined different kinds of stressors: challenges and hindrances. Jeffery LePine and his team at University of Florida expanded on this and found that challenge demands are linked to improved job performance; hindrance demands lead to impaired work engagement and performance.

Opportunities and Obstacles

We’ll get to some examples, but for now know that:

  • Challenge demands cost energy but are viewed by workers as opportunities to grow, improve, advance, achieve.
  • Hindrance demands cost energy and are perceived as unnecessary obstacles, thwarting personal growth, wellbeing, and achievement.

(By the way, there also are different types of resources — for example, job resources and personal resources. Job resources include things like performance feedback, training, and autonomy; personal resources include self-efficacy (confidence in your ability to have an effect) and optimism. For a more detailed and expert analysis of different types of demands and resources, see Maria Tims and Arnold Bakker’s article, “Job Crafting: Towards a New Model of Job Redesign.”)

Demands-Resources Job Crafting

In job crafting with the JD-R model, employees

  1. Seek resources
  2. Seek challenge demands
  3. Reduce hindrance demands

Some of what researchers point to as resources — like performance feedback and training — are sometimes viewed by employees as hindrances. And occasionally there’s a fine line between a resource like autonomy and a hindrance demand like role ambiguity.

For clarification, it’s helpful to see what experts consider demands and resources. Below are examples adapted from a book chapter called “A Critical Review of the Job Demands-Resources Model: Implications for Improving Work and Health,” by Wilmar Schaufeli and Toon Taris.

Job Demands

  • Cognitive demands
  • Computer problems
  • Downsizing
  • Emotional demands
  • Interpersonal conflict
  • Job insecurity
  • Work-family conflict
  • Difficult customers
  • Physical demands
  • Reorganization
  • Inadequate rewards
  • Role ambiguity
  • Harassment
  • Unfavorable shift work schedule
  • Unfavorable work conditions
  • Work pressure
  • Work-home conflict
  • Work overload

Job Resources

  •  Advancement
  • Appreciation
  • Autonomy
  • Rewards
  • Goal clarity
  • Information
  • Innovative climate
  • Leadership
  • Professional development
  • Participation in decision making
  • Performance feedback
  • Procedural fairness
  • Positive customer interactions
  • Quality of the relationship with the supervisor
  • Safety climate
  • Social support
  • Skill utilization
  • Strategic planning
  • Task variety
  • Team harmony
  • Trust in management
  • Values

Personal Resources

  • Emotional and mental competencies
  • Intrinsic motivation
  • Self-determination
  • Optimism
  • Organization-based self-esteem
  • Resilience
  • Self-efficacy
  • Values

Wellbeing — What Is It Good For?

in Uncategorized, Wellbeing, industrial organizational psychology, job crafting

Pie illustrations depicting wellbeingIn previous posts about the transition from wellness to wellbeing, I neglected to address the studies of wellbeing — including many attempts to define it — that were done before corporate America appropriated the term.

As legendary occupational psychologist Sir Cary Cooper says, “Define wellbeing? We can’t even agree on how to spell it Hyphen or no hyphen?” (I’ve paraphrased Sir Cary.)

One employer survey defined wellbeing by contrasting it with health and wellness. In an article called “Survey Shows Shift from Wellness to Holistic Wellbeing,” the investigators declared:

“Wellness programs focus on physical health while well-being addresses ‘all things that are stressors in an employee’s life.’

So far, so good.

Then they wrote:

Improving employee health was the most frequently mentioned (82%) reason for offering well-being programs, followed by: decrease medical premiums and claim costs…”

If those two quotes don’t have you scratching your head, you’re reading too fast. Please back up and keep rereading until you’re appropriately distressed.)

Gallup’s Essential Elements of Wellbeing

In recent years, Gallup describes wellbeing, based on their massive surveys, as consisting of (these are verbatim):

  • Purpose*: liking what you do each day and being motivated to achieve your goals
  • Social: having supportive relationships and love in your life
  • Financial: managing your economic life to reduce stress and increase security
  • Community: liking where you live, feeling safe, and having pride in your community
  • Physical: having good health and enough energy to get things done daily

In 2010, Gallup’s Tom Rath and James Harter published “Wellbeing: The Five Essential Elements.”  The book served up the same five elements that Gallup advocates today, except the book used the label “Career,” whereas Gallup now calls the same element “Purpose.” Hmmm.

Gallup, with their partner Healthways (which eventually was acquired by Sharecare — creating the Gallup-Sharecare pair) argues that employers should address all five elements of wellbeing. For a price, they offer consulting services to help.

Employers faithfully adopted the five elements, depicting their wellbeing program goals with circles perfectly divided into equal parts — each representing one of the five elements — sometimes shoehorning in another element or two, like “emotional,” “environmental,” or “spiritual.”

But employers have not been well-served by their simplistic pie diagrams, which are used as virtual checklists to perfunctorily confirm that each element is addressed…

A fragmented effort to address what is in wellbeing, rather than a cohesive strategy to support what wellbeing is, may be one reason why, in practice, nothing but the name has changed.

Subjective Wellbeing

Since his groundbreaking review, “Subjective Wellbeing,” first appeared in 1984, psychologist Ed Diener has probably published more wellbeing research than anyone. Though Diener evaluated the elements of what he calls “subjective wellbeing,” he defined it not by its elements but by the experience. To Diener, wellbeing is…

“…how people evaluate their lives — both at the moment and for longer periods… These evaluations include people’s emotional reactions to events, their moods, and judgments they form about their life satisfaction, fulfillment, and satisfaction with domains such as marriage and work. Thus, subjective wellbeing concerns the study of what lay people might call happiness or satisfaction.

“Happiness or satisfaction.” Isn’t that what we always knew wellbeing to be, before we picked it apart?

I Feel Good! 

With the various definitions of wellbeing circulating helter skelter, Uncle Sam (in the form of the CDC) played peacekeeper:

“There is no consensus around a single definition of well-being, but there is general agreement that at minimum, well-being includes the presence of positive emotions and moods (e.g., contentment, happiness), the absence of negative emotions (e.g., depression, anxiety), satisfaction with life, fulfillment and positive functioning. In simple terms, well-being can be described as judging life positively and feeling good.”

Rath and Harter’s description of wellbeing and other definitions of wellbeing emphasizes how you get there — the road to wellbeing. Diener and other psychologists emphasize how you are when you arrive.

Wellbeing and Burnout

Diener mentioned marriage and work, referring to domain-specific wellbeing. Here’s where that comes into play…

In job crafting research — as with a lot of organizational development research — “wellbeing” often is measured in the work domain only. Work wellbeing doesn’t just mean job satisfaction; it goes deeper to how employees are.

How do you measure how employees are at work?

For perspective, consider the symptoms of burnout:

  1. Exhaustion
  2. A feeling of not making a difference
  3. Cynicism

It’s not unreasonable to say that the opposite of burnout is work wellbeing — having energy, purpose, and optimism at work. This is why burnout metrics have, sometimes, been used to measure work wellbeing.

Focusing on work wellbeing — which, on the surface, seems to be just one domain — may be heresy to employee wellness leaders looking to check off their list each element of wellbeing.

But employee wellbeing programs risk getting in their own way if they try to do too much. Would it make sense to help employees thrive at work — the domain over which employers have most control — before trying to get them to thrive in, say, relationships, community, or even physical health?

On one hand, focusing on work wellbeing seems to contradict arguments against checking the elements off one-by-one. On the other hand, if the elements are interdependent, bolstering work wellbeing helps support the other elements. And if the others are supported at the appropriate time and place, work wellbeing will benefit.

Job Demands-Resources: Untangling Stress and Motivation

in Stress, job crafting
Still shot from Charlie Chaplin's "Modern Times" illustrating high demands, low resources, no social support on an assembly line.

High demands, low resources. No social support.

To understand what job crafting has to do with employee health and wellbeing, it’s important to understanding the inner workings of job stress and motivation.

In a previous post — “I’ve Seen the Future of Employee Wellbeing: It’s Name Is Job Crafting” — I explained how, in 2001, Amy Wrzesniewski and Jane Dutton proposed that employees tweak their job tasks, workplace social connections, and perspective about their role to gain a greater sense of purpose and meaning, potentially leading to better job performance.

Around that same time, in the Netherlands, Evangelia Demerouti, Arnold Bakker, and others introduced their model of Job Demands-Resources (JD-R), which has since been fine-tuned and validated as relevant to a full range of occupations and outcomes in countless studies around the world.

If you’re familiar with job stress research, you know that job stress has causes, and shouldn’t be dismissed as a choice employees make.

Forget trendy notions that “stress is good.” It’s wishful thinking based on cherry-picked evidence. If stress is so great, why aren’t employees demanding more of it?

Forty years of research has shown that harmful job stress is a result of jobs that have low levels of autonomy and high demands.

Job Demands and Autonomy Are Linked to Health Problems

Over the years, job autonomy (or control) has been defined different ways, but can be broadly understood as limited flexibility (for example, with the tasks of the job) and limited decisional latitude, meaning the employee isn’t permitted or encouraged to make decisions in their work or about their work.

Job demands originally meant the psychological intensity of work, but ultimately can be understood to include workload, time pressure, and physical demands.

Job strain illustration shows relationship of demands, control, social support, and health.

Job strain

Robert Karasek introduced the theory of demands and control in 1979. He and others have shown that jobs in which workers consistently encounter high job demands with low job control — the combination of which is called job strain — are linked to a variety of health issues, especially high blood pressure and cardiovascular disease, as well as depression, anxiety, burnout, and metabolic disorders. Reducing job strain can improve productivity.

Karasek later learned that social support “buffers” the negative effects of high-strain jobs. Social support originally meant supervisors’ and co-workers’ support for performing job tasks, but can be understood in all of the many ways it’s been defined: Having a sense of “belongingness” at work; having co-workers who are empathetic and confidantes; having supervisors who take a genuine interest in the personal and professional lives of team members; and having a best friend at work.

In sum, high demands and low control are an unhealthy combo. (High demands and high control are not necessarily bad.)

Effort-Reward Imbalance Is Linked to Health Problems

Unhealthy job stress has been framed in other ways. Germany’s Johannes Siegrist found that work in which the required effort is disproportionately high compared to the job rewards— effort-reward imbalance — leads to the same kinds of health problems that result from job strain. “Rewards,” here, doesn’t just mean financial compensation, but also career opportunities and level of esteem within the organization.

The effort-reward imbalance model reminds me of an encounter I once had with a business analyst who transferred to another department because she didn’t feel valued in the department she was hired into. When I asked her, “What would have made you feel more valued?” her answer was not “better pay” or “someone saying ‘good job’”…

“I just wanted someone to listen to my ideas,” she told me.

A worker who doesn’t feel valued (i.e. esteemed) by being “listened to” is likely to have a higher level of disengagement and health impairment. This offers a glimpse into how management style, job design, organizational culture, performance, turnover, health, and wellbeing are all interconnected.

Overtime, Job Insecurity, Injustice, and More…

Several other causes of job stress have been identified, and most of them can in some way fit into the demand-control and/or the effort-reward imbalance model:

      • • chronic overtime
      • • job insecurity
      • • work-life conflict
      • • role ambiguity (not being clear of what’s expected, receiving contradictory direction, duplication with other workers’ roles, or not understanding how the work fits into the overall organization — all of which are among the most common complaints I’ve heard from employees who report high job stress).
      • • organizational injustice (being treated unfairly, which at the extreme includes bullying and harassment)
      • • lower levels of status within the organization
      • • sustaining high levels of vigilance (e.g. first responders, air traffic controllers, etc.)

Back to Bakker

The overlaps between and the nuances of these job stress theories makes them difficult to understand and apply. That’s where Bakker and Demerouti’s Job Demands-Resources model comes in. While building on the existing theories and expanding upon them, it also provides a simpler way of making sense of job stress and motivation. I consider it a comprehensible and practical  unifying theory.

JD-R posits that all job traits can be categorized as either demands or resources. 

      • • Demands require sustained effort from employees. They’re an expenditure of personal energy.
      • • Resources help fuel progress toward work-related goals. They’re restorative, buffering the effects of job demands —and activating personal development.

I interpret JD-R to mean that Karasek’s “demands,” Siegrest’s “efforts,” as well as role ambiguity, job insecurity, injustice, tedium, and work-life conflict are demands.

Job autonomy, social support, rewards, recognition, feedback, task variety, and training are examples of resources.

Side note: If you’re familiar with Edward Deci and Richard Ryan’s self-determination theory — popularized in the Daniel Pink bestseller, Drive — which tells us that motivation and flourishing depend on autonomy, competence, and relatedness (i.e. social connection), you may recognize that job resources generally can be matched to the components of self-determination.

So…

      • • Demands regulate job stress. 
      • • Resources regulate job motivation and engagement. 
      • • And the two forces may act upon each other.

Looking Forward…

That’s enough theory for now. What I’ve come to appreciate about JD-R is how, according to research by Bakker and others, it serves as a foundation for a practical application: job crafting.

JD-R takes job crafting beyond meaning and purpose — which has received most of the public attention — and ties it directly into health and wellbeing.

I’ll spell this out further in a future post, and also draw the important distinction between positive and negative job demands. I’ll share what research shows about the effectiveness of job crafting interventions for improving employee wellbeing, work engagement, absenteeism, performance, and productivity. And I’ll offer evidence-based tips on how you can prime your organization for job crafting.

*************

For an excellent overview, see Bakker and Demerouti’s 2016 article: Job Demands-Resources Theory: Taking Stock and Looking Forward

Dealing With Burnout

in Uncategorized, Stress, industrial organizational psychology

burnt out personIf you can find some downtime (or some treadmill time?), listen to “Dealing With Burnout” the Wisconsin Public Radio Morning Show. One of the guests was Monique Valcour PhD CPCC, who has a gift for articulating, in super-practical terms, the connection between work and wellbeing. Monique explains what burnout really is, and delivers keen insight when the first caller makes a reference to the role of autonomy in addressing his own burnout. She talks about burnout as an “interpersonal phenomenon” and notes the supportive effects of mindfulness and emotional intelligence. And she provides practical tips for workplace leaders.

By the way, not only is it essential for us wellness professionals to address the burnout that occurs amongst employees, but I’m observing that it’s increasingly common within HR, Employee Benefits, and Employee Wellness teams. So if you don’t feel the need to learn about burnout for your organization, learn about it as an act of compassion for yourself.

https://www.wpr.org/shows/dealing-burnout

 

 

6 Surprising Ideas That Will Transform the Employee Wellness Industry (Webinar)

in Uncategorized

surprise faceRajiv Kumar, M.D., and I explore 6 surprising ideas that will transform employee wellness in this webinar recording from Thursday, February 22, at 2 PM ET.  

I’ve had the pleasure of co-presenting with Rajiv on several occasions, and the conversations always take a turn toward the unexpected. I elaborate on my latest passion, job crafting, and how it may surpass other popular solutions for health-related job stress, burnout, and disengagement.

Rajiv brings his unique perspective as a community-minded entrepreneur, physician, and vendor. I’m always enriched by our conversations, and I think you will be, too.

19 Tips for Employee Wellbeing Program Evaluation

in Uncategorized, Employee Wellness Programs

Wellbeing Data ChartsThe process of evaluating employee wellbeing and sustainability programs depends on the organization and its goals.

Here are tips that can be applied in almost any situation to assure your findings meet your needs:

  1. Have a plan. Include program component evaluations, communication (and other process) evaluations, and overall program outcome evaluations.
  2. Identify metrics based on program goals. You wouldn’t, for example, spotlight biometric screening data to measure a program’s effect on culture or employee engagement.
  3. Rely on data. Use story and data visualization to communicate and provide insight into data.
  4. Benchmark against reference groups, including vendor book-of-business, national norms, and (yes) sometimes non-participants.
  5. Understand biases, including the powerful affect of selection bias.
  6. Leverage existing sources of data, such as HRAs, biometrics, safety, employee engagement surveys, EAP, HR info systems, and disability.
  7. Identify relationships between findings. How are physical health, productivity, employee engagement, behavioral health, and well-being strategies affecting each other?
  8. When using surveys, use validated instruments, when possible.
  9. Engage in-house experts (eg data analysts), if available.
  10. Require vendors and consultants to provide expert evaluation consultation.
  11. Take vendor self-evaluations with a grain of salt.
  12. Be conservative in conclusions.
  13. Communicate evaluation findings throughout the organization, including to participants.
  14. Be transparent about findings, even when they are disappointing.
  15. Follow participant cohorts to show change over time.
  16. Generally, seek to measure sustained outcomes, not just results immediately post-program.
  17. Understand intent-to-treat methodology, and use it if you’re trying to do a rigorous analysis of health interventions.
  18. Evaluation goals differ – for example, garnering program support vs. quality improvement. Establish methodology accordingly.
  19. If in doubt,  strive to be as rigorous as possible, but don’t get bogged down in perfectionism unless you’re publishing research.

If your organization needs help with its program evaluation, contact Jozito LLC’s principal consultant, Bob Merberg, using this website’s contact form.

I’ve Seen the Future of Employee Wellbeing. Its Name Is Job Crafting.

in job crafting

Crafting clay

First, the Premise: Work Shapes Wellbeing

The foundation of employee wellbeing isn’t employee behavior — it’s workplace exposure. Exposure to things like…

  • the physical environment,
  • the psychosocial environment,
  • the policies of the organization,
  • the work itself.

Designing jobs to optimize these exposures is a direct path to creating healthier work.

The employer that values employee wellbeing will design jobs that offer

  • autonomy,
  • manageable demands,
  • well defined roles,
  • fairness,
  • appropriate rewards,
  • plenty of personal and professional support.

As the business world crams countless sections into its wellbeing pie charts, it persistently omits the core: For a sustainable workforce, healthy work comes first.

What Is Job Crafting?

In job crafting, employees tweak any combination of…

  • their tasks,
  • their workplace interactions,
  • the way they view their jobs.

One of the most commonly cited examples comes from Amy Wrzesniewski and Jane Dutton, who first coined the phrase job crafting in 2001. In their study of hospital housekeepers, some workers distinguished themselves by envisioning their role as part of the care team, taking the initiative to chip in where they could to make the environment more patient-friendly — adjusting a picture on the wall of a patient’s room, delivering a glass of water, or spending more time interacting with patients and visitors.

The researchers wrote,

When hospital cleaners integrate themselves into patient care functions, they are able to see their work as being about healing people and to see themselves as a key part of this process, thus enhancing work meaning and creating a more positive work identity.

A variety of workers studied, from machine operators to engineers to sales professionals, have been found to experience greater job satisfaction, better performance, less burnout, and enhanced wellbeing by bringing more meaning to their jobs via self-initiated or intervention-based job crafting.

I’ve come to see job crafting as the workforce sustainability intervention many of us have sought: An evidence-based, employee-centric methodology that can enhance employee wellbeing in a manner aligned with employers’ priorities.

Job crafting is not the solution, but it may be the keystone for employers that have their house in order. It’s one answer to the question, “Okay, we value autonomy, employee engagement, a supportive environment, and the rest… But what do we do about it?”

Job crafting is a tool — not a substitute — for good management.

If you may be interested in hosting a job-crafting beta workshop later in the coming year, touch base via the Jozito.com contact form.


A version of post was originally published on LinkedIn on December 28, 2017.

9 Hopes – Not Predictions – For Employee Wellness in 2018

in Stress

employee wellness predictionsInstead of offering predictions about what will happen in employee wellness in the coming year, here is what I hope to happen:

  1. When we advocate new strategies, we’ll cite peer-reviewed evidence to support our case.
  2. We’ll assess and listen carefully to what employees really want.
  3. Organizational leaders will recognize that employee wellbeing is everyone’s responsibility — not just the wellness coordinator’s.
  4. Wellness coordinators will recognize that employee wellbeing is everyone’s responsibility — not just theirs.
  5. We’ll study models of job stress, including demand/control/social-support (job strain), effort-reward, organizational fairness, and job demands-resources (JD-R), and understand their relevance to overall employee wellbeing.
  6. We’ll open up to the possibility that behavior change isn’t the be-all-and-end-all of employee wellbeing.
  7. We’ll expect vendors to accept their fair share of financial risk for results, without just baking it into their pricing.
  8. We’ll identify a forum for wellness practitioners and industrial/organizational (I/O) psychologists to experience cross-learning about assessment and enhancement of work, wellbeing, and productivity.
  9. Our major wellness conferences will connect their attendees with nonprofit (or under-resourced) employers in their host cities to model wellbeing interventions for employees who otherwise might not have access.

This post is excerpted from 9 Employee Wellness Trends that Won’t Happen in 2018 (and 9 that Should), originally published on LinkedIn on December 12, 2017.

The Secret About Wearables Is That There Is No Secret

in Uncategorized, Wellbeing, Employee Wellness Programs

physical activity trackersLast year, online media had a field day when a survey showed that one third of respondents who owned a “wearable” activity tracker stopped using their device within six months. The firm that conducted the survey referred to this as “the dirty secret of wearables.” But it’s premature to judge this disengagement rate, and there’s no secret to keep. Sixty-six percent adherence for wearables after six months may, in fact, be something to celebrate.

Is It Time to Disengage from Disengagement Rates?

We haven’t identified universally accepted goals for activity trackers (by “trackers,” we’re talking here about devices like Fitbits, Jawbone Ups, and the like). Is the purpose to increase activity? To lose weight? To (perish the thought) have fun? Without goals, there’s little we can say about effectiveness or the significance of disengagement rates.

The assumption behind the negative publicity for disengagement rates implies that users should wear their trackers indefinitely. But…Says who? Many consumers wearing a tracker for the first time will see, within a few days, that they aren’t as active as they thought. This may be a first step to modifying behavior, even if they ultimately rely on non-tracker strategies to make changes, and even if those strategies take place at a later date.

Business Insider writer Erin Brodwin recently published an article called, I Tried Fitbit for a Month, and Taking It Off Was the Best Decision I’ve Made. Judging from the title, we might think that Brodwin’s story is a testimonial to the transience of tracker engagement (or that she needs to make better decisions in her life). And it may be. But this observation she makes near the end of the piece may exemplify unexamined potential of wearables:

I still do some of the healthier things I learned to do with my Fitbit, like taking the stairs at work and going for a walk when I take a phone call.

In Brodwin’s case, sustainability of her Fitbit use would have been the wrong metric if her goal was to increase physical activity.

Do One Third of Users Disengage with Wearables after Six Months? Or Do Two Thirds Continue?

What benchmark are we using to judge sustainability of engagement with wearables? Do we compare it to the 20% of patients that drop out of psychotherapy early? Or to the attrition rate for Crossfit, physical therapy, yoga, walking groups, Weight Watchers, or gym attendance? What about mindfulness, our panacea du jour? What percentage of mindfulness practitioners sustain their efforts for more than six months?

I don’t have credible citations for disengagement rates on any of these potential benchmarks, because hardly anyone’s even asking the question. But, by most accounts, a 66% adherence rate after six months compares favorably to…well, just about anything that requires effort.

Previous research on pedometers and early-day accelerometer devices has shown they can be useful tools for increasing physical activity…when they’re integrated with a sound behavioral program. And this was the optimistic conclusion of the “dirty secret” survey — that use of wearables can be sustainable when integrated with behavioral approaches.

Through my job, I’ve overseen the distribution of thousands of pedometers and hundreds of modern tracking devices to people engaged in top-tier behavioral programs lasting several weeks, often offered periodically throughout the year. The pedometer users, I did indeed find, are usually eager to abandon their device in the junk drawer after a program ended. But those who stop wearing their pedometer after eight weeks tend to be perfectly happy to resume wearing it when the next program rolls around. And I’ve seen unpublished data showing that the effects of this intermittent participation on activity levels is sustainable for more than a year. Using it or not using it for the first six months of ownership doesn’t seem essential.

Our wearable technology is ahead of our research. Do we know what consumers expect from trackers? Not everyone wearing a tracker wants to change. Some may be quantified-self devotees. Some enjoy a tracker as an expensive toy.

As for me: I need to have an activity tracking device because I’m in the business, and I’m extra motivated to continue so that I can contribute my data as a subject in the Heart Study (which, I hope, may ultimately resolve some of our questions about wearables). If my job was unrelated, I doubt I’d pony up the bucks for a glorified pedometer.

Calorie-counting apps have come under similar criticism, but there’s no arguing that expectations of these apps are more clearly defined. Consumers come to these apps to lose weight, though research shows that attrition is high and that the apps, perhaps like wearables, are useful as a measurement tool and not a standalone strategy.

I use MyFitnessPal to track calories for 3 to 4 weeks each year. In the first three weeks I used it, I suffered the revelation that I consumed more daily calories in snacks than I did in meals. While I caution that n=1 — my experience may be irrelevant to anyone else’s — approximately three weeks was all it took to trigger a lasting change in my eating patterns. I consider that a win and, as of this moment, it’s no secret.

[This post was originally published on Medium.com on May 18, 2015]

Dollars…and Bias…Who Cares? Oh My!

in Employee Wellness Programs

Wizard of Oz man behind curtainPay No Attention to the Magnate Behind the Curtain?

In 2000, a bunch of diet “gurus” were assembled to debate the pros and cons of different weight loss diets. Robert Atkins, Dean Ornish, John McDougall, the Sugar Busters guy, Barry Sears, and Keith-Thomas Ayoob from American Dietetics Association were in attendance.

At the time, the Atkins diet was booming in popularity. The low-fat guys demanded from Atkins data supporting his advocacy of high-fat, high-protein, low-carb diets. Atkins said he hadn’t been able to secure research funding.

Ayoob chided, “Excuse me, 10 million books in print and you can’t fund the study?”

Eventually, Atkins funded his own studies, which demonstrated that his’ conclusions about carbs and fats were not something to be ridiculed (they influences much of today’s emerging thinking about weight loss). Many of these studies were published in distinguished journals, such as the New England Journal of Medicine. Regardless, they were viewed warily because they were funded by Atkins.

In other words, skeptics belittled Atkins for not funding studies of his diet. Then, when he did fund them, they dismissed the results as biased…because he funded them.

Damned if you do, damned if you don’t.

Almost all employee wellness research is commercially funded, and I do believe bias and distortion are prevalent. On the other hand, I respect companies that endeavor to publish their results.

My job, as a consumer of science information is:

  • to be aware of the potential for bias;
  • to try to understand how bias may or may not influence outcomes;
  • to seek less biased sources;

…and then to use my own critical thinking skills to reach or reject a conclusion based on all the information I have at hand.

[This post was adapted from a reply I wrote in response to Ted Kyle’s blog post Head Spinning Bias About Funding Bias. Ted blogs prolifically about obesity on his ConscienHealth – website, and is uncommonly faithful to scientific evidence. He’s a voice that needs to be heard.]

What Is Workforce Sustainability?

in Uncategorized, Wellbeing

Modern Office for Sustainable Workforce

I’ve compared, in a separate post, the terms health, wellness, and wellbeing.

But even “wellbeing” doesn’t go far enough. The term, as it’s typically used in employer circles, overlooks the interaction between an employee’s wellbeing and their work — the job conditions, the people they work with, the support they receive… indeed, all the way to the very way work is done. The consequences of a sustainable workforce are the very ones employers seek: work engagement, productivity, consistent attendance, and retention.

One of the best descriptions of workforce sustainability is offered by researchers Ellen Kossek, Monique Valcour, and Pamela Lirio in their chapter, The Sustainable Workforce: Organizational Strategies for Promoting Work–Life Balance and Wellbeing, published in the book Work and Wellbeing: A Complete Reference Guide:

“A sustainable workforce is one where the work environment is caring and supports employee wellbeing. Employees are not seen as primarily resources that can be deployed (and depleted) to serve employers’ economic ends. Their skills, talent, and energies are not overused or overly depleted. They are not faced with excessive workload nor with a relentless pace of work for weeks or years on end. During times of crisis (e.g., natural disasters, sickness), employees are given time to recover or seek the extra resources they need to be able to perform in the future. Burnout is avoided and workers are given time for renewal.

“When human resources are used in a sustainable way, employees are not only able to perform in-role or requisite job demands, but also to flourish, be creative, and innovate. Sustainable human resource management practices develop positive social relationships at work, which enhances business performance, including greater cohesion among organizational members, commitment to common purpose, hope for success, resilience, knowledge sharing, and collaborative capacity.”

There’s no secret sauce to achieving a sustainable workforce. But it’s important to understand the essential elements of workforce sustainability when implementing a wellness program, so that program offerings are crafted through a sustainability lens.

Health, Wellness, and Wellbeing Are the Same

in Uncategorized, Wellbeing

dimensions of wellness

I recently read an article about business’s revolutionary transition from employee wellness to wellbeing. “Historically speaking,” the author wrote, “wellness has been thought of as strictly pertaining to physical health, usually measured by biometrics.”

But, accurately speaking, this is not so.

Of course, there’s no single arbiter who can proclaim what exactly health, wellness, or wellbeing mean, but it’s worth understanding some of the ways these words have been interpreted in order to fully appreciate the implications, or lack thereof, of the “transition” from wellness to wellbeing

“Health” was defined by the World Health Organization (WHO) in 1946 as

a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.

WHO’s definition, incorporated into its constitution, remains unchanged to this day. But in 1986 the organization held an International Conference on Health Promotion in Ottawa, which resulted in the famous Ottawa Charter for Health Promotion that elaborated on the definition, stating,

An individual or group must be able to identify and realize aspirations, to satisfy needs, and to change or cope with the environment. Health is, therefore, seen as a resource for everyday life, not the objective of living. Health is a positive concept emphasizing social and personal resources, as well as physical capacities.

The Charter went on to list the conditions for health: peace, shelter, education, food, income, a stable eco-system, sustainable resources, and social justice. A far cry from biometrics.

In the late 1950s, the chief of the US Office of Vital Statistics — Halbert Dunn, MD — described a dynamic state-of-being he called “high-level wellness.” This is generally considered the founding of wellness, and Dr. Dunn’s sermon-like lectures reveal his concept to be anything but a simple embodiment of physical health. Dr. Dunn said…

The state of being well is…a fascinating and ever-changing panorama of life itself, inviting exploration of its every dimension.

I believe Dr. Dunn was amplifying — not refuting — WHO’s original definition, and the Ottawa Charter later adopted much of his take on wellness as a never-ending interaction with the environment.

But Dr. Dunn’s framework may have proven too cosmic for the mainstream. And many thought leaders have since distilled wellness into the sum of its various dimensions.

The National Wellness Institute adopted a model that incorporates six dimensions of wellness — occupational, physical, emotional, spiritual, intellectual, and social. Others have divvied wellness up into five, six, seven, or eight dimensions, sometimes tossing in a “relationship” dimension, sometimes “environmental,” “financial,” or “community.” A quick image search reveals a galaxy of multidimensional wellness models in the shape of pies, hexagons, prisms, Venn diagrams, concentric circles, and geodesic domes.

I don’t know exactly how “wellbeing,” in the last few years, worked its way into the hearts of employers and the wellness industry. But one catalyst probably was the bestselling book, The Five Elements of Wellbeing, by Tom Rath and Jim Harter. Both authors are workplace consultants with Gallup (a partner of wellness vendor Healthways) and entrepreneurial marketers with a track record of successfully persuading employers to their way of thinking.

Rath and Harter argue, based on Gallup findings, that wellbeing is more profound than health and wellness, incorporating career, social, financial, physical, and community wellbeing. Sound familiar?

In practice, employers are rallying around mindfulness programs and financial planning, and repackaging stress management as resilience, and using these incremental expansions of the status quo as markers to distinguish wellbeing from wellness. Ultimately, the transition amounts to little more than a name change.

That’s fine.

I’m more than happy to dispose of the word “wellness.” I never cared for it — not because of its definition, but because it has failed to resonate with employees or the public at large. And I see no harm in calling it wellbeing instead of wellness. Certainly, while the employee wellness industry has been celebrating this “transition,” I doubt many employees have noticed a difference.

Besides, I’m open to the evolution of language, as long as it isn’t contrived to cover up a deception (like calling participation “engagement,” which I’m sure no self-respecting wellness professional would ever do).

Here’s my bottom line based on this incomplete and superficial exploration of the terms health, wellness, and wellbeing: Some people are inclined to see connections, whereas others are more drawn to compartmentalize. Maybe surgeons and benefits directors are more likely to see what’s tangible and quantifiable, while artists and farmers see the whole and the dynamics it contains. Both points of view probably deliver value.

Either way, I’m guessing that anyone who views health and wellness as only physical phenomena is likely to see wellbeing the same way. Others who view these concepts holistically are likely to do so regardless of the labels we attach to them.

Health, wellness, wellbeing: In the end, what we call it won’t matter as much as how we think of it…and how we act on it.

(Originally published on LinkedIn May 3, 2016)