Engaging Employees With a Healthy Nudge

3 strategies that are proving to be effective in moving employees to better engagement in healthy health practices.

By Peter Saravis, CEO and Co-Founder, Evive Health

One of the fundamental goals of any Human Resources professional is finding the most effective way to motivate employees and to engage them in ways that allow them to be their very best. But central to this simple truth is the reality that employees cannot perform as hoped if they are not healthy. And that puts corporate America at a disadvantage.

Poor health is costing American business billions of dollars annually in health-care premiums, absenteeism, accidents, and other related costs. In one telltale example, the latest Gallup-Healthways Well-Being Indexreports that workers who are above normal weight or have at least one chronic health condition take an extra 450 million sick days compared with healthy workers —resulting in more than $153 billion in lost productivity annually (http://www.gallup.com/poll/150026/Unhealthy-Workers-Absenteeism-Costs-153-Billion.aspx?utm_source=tagrss&utm_medium=rss&utm_campaign=syndication).

Amidst that reality, it is no wonder that health and wellness programs are becoming more and more common in the workplace. The 2011 Kaiser Family Foundation and Health Research and Educational Trust annual survey of employer health benefits found that 67 percent of companies with three or more employees that offered health benefits also offered at least one wellness program (http://ehbs.kff.org/pdf/2011/8225.pdf). These may include annual physical examinations, exercise or physical fitness programs, vaccinations, and preventive screenings.

With increased data to support their assumptions, employers see evidence that making such programs available to their employees makes sense—dollars and cents. But what they also are seeing is that offering such programs isn’t enough. Getting employees to use them is turning out to be the real challenge.

The Power of Behavioral Economics

Fortunately, there are ways to engage employees in health maintenance activities that are proving to be effective. Research that appeared in the summer 2011 issue of The Proceedings of the National Academy of Sciences demonstrated that “nudging” employees in the right way can lead to significant improvements in their level of engagement in health initiatives. The research was conducted by researchers at The Wharton School; Stanford University; Yale University; Harvard University; and Evive Health, an innovator of technology solutions that provides individuals with personalized health and wellness tools that improve their health decision-making. In the study, 3,272 employees at a large Midwestern firm were randomly sent one of three reminder mailings encouraging them to obtain a flu shot at an on-site clinic. Some of the mailers prompted recipients to write down the date and time when they planned to get the shot. That mailer resulted in a 37.1 percent compliance rate where the employees actually obtained their vaccination—an increase of 4.2 percentage points over those who received an identical mailer with no prompt. The write-in prompt mailer was most successful with recipients who could only obtain on-site flu shots on a single day: Compliance among these employees was 8 percentage points higher. The study’s lead investigator, Katherine L. Milkman, Ph.D., of The Wharton School, concluded “Prompting people to simply write down the specific date and time when they plan to engage in a health activity—in this case, getting a flu shot—is a highly effective and zero-cost method for improving behavior. We anticipate similar prompts could be used to increase employee engagement in many other healthy behaviors.”

The tactics used in the Wharton research were based on behavioral economics, the study of cognitive, emotional, social, and psychological factors that people employ in decision-making. Although behavioral economics has been used to study “buy” decisions in other industries, these strategies only recently are being applied to health care. The results can be impressive.

When the State of Nebraska needed to boost participation in its employee wellness plan, it began employing behavioral economics tactics that increased compliance with preventive care screenings by 19 percent in just nine months. DTE Energy Company in Michigan has more than 10,000 employees in 125 locations and rebranded its multifaceted health and wellness promotion program in 2010. Since then, DTE has been using behavioral economics-based mailings to nudge employees toward its wellness programs. In just the last year also, DTE has seen a relative increase in adherence to recommended preventive screening of more than 12 percent.

Lessons Learned

How can you apply “nudge” tactics to boost compliance with activities designed to keep your workforce healthy? Here are three strategies that are proving to be effective in moving employees to better engagement in healthy health practices:

  1. Encourage commitment: DTE Energy garnered success with a mailing for Weight Watchers created specifically for couples. It prompted the recipients to fill in together the digits on two scales representing their “goal weight” for the end of the month. The spouses then can serve as a coach or motivator to keep each other on track.
  2. Inspire action: Research has revealed that people are more likely to act on information when they must make the effort to discover it for themselves. The State of Nebraska used this concept in a scratch-off mailer that revealed the actual dollar amount an individual would save by enrolling in his or her best PPO option. The mailer increased the number of people electing to choose the plan by 10.9 percent over the previous year.
  3. Include a retention item: “Lumpy” mailers are intriguing and more likely to be opened. Including a small item such as pen or refrigerator magnet makes the recipient feel more obligated to follow through on the requested action.One employer used a refrigerator magnet to remind recipients to schedule a colonoscopy by a certain date. The reminder tool increased colonoscopy appointments from 6 percent to nearly 10 percent.

Little nudges like these may seem like a simplistic way to attain the bigger goal of greater employee engagement and lower health-care costs. But used collectively, they can have a big impact on overall employee health, one person at a time.

Peter Saravis is co-founder and CEO of Chicago-based Evive Health, an innovator in designing personalized communication tools that motivate individuals to engage in health and wellness enhancement activities that improve their health, lower health-care costs, and lead to a happier and healthier lifestyle. Contact Peter at peter@evivehealth.comor visit http://www.evivehealth.com.

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