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Wendy Wood

Health Care

Nudging Your Staff to Healthier Habits

The biggest reason employees fail to participate in wellness programs is lack of time

Published: Monday, February 12, 2018 - 13:02

Employers have a stake in their staff’s health. It’s not just a matter of keeping health insurance premiums in check which is a consideration in countries without universal healthcare. It’s also about maximizing employee engagement and productivity, and even happiness.

Promoting health habits is no easy task, and most corporate wellness programs focus on the potential long-term benefits. But to reap such benefits, firms would do well to use a short-term lens. What can they do to make it easier for employees to repeat a desired behavior today, tomorrow, and the day after?

There’s an analogy to be made with new year’s resolutions, which we all love to make but promptly drop. Our resolutions tend to concern things that are “good for us” in the long-term, such as exercising to “improve our health” or saving money to “grow our retirement fund.” We rarely choose resolutions that we can sustain; instead, we focus on the most challenging ones. We also fail to consider how our beloved habits may hamper our willingness to follow through with our new goals.

Furthermore, we rarely think of our resolutions in scientific terms. That is, we don’t necessarily think of applying techniques that have been proven to improve the possibility of success. In the organizational field, what if employers used such techniques to help their staff conquer the evils of smoking, stress, inactivity, and obesity?

In a paper co-authored with David Neal from Duke University, I rounded up the best-known scientific studies on health-habit interventions. This review showed that a two-pronged approach, which includes promoting healthy habits while simultaneously breaking unhealthy ones, yields the best long-term results.

Forming healthy habits

Simply giving people information won’t compel them to change their habits. During the 1990s, a public health campaign nearly tripled Americans’ awareness that they should eat at least five servings of fruit and vegetables per day. Unfortunately, actual fruit and vegetable consumption remained flat during that period and even decreased later on.

Healthy habit formation is not about will or good intentions, either. Instead, a successful intervention involves creating opportunities for the consistent repetition of specific behaviors—ones that are rewarding. For example, a firm may offer incentives for staff to cycle to work on a regular basis by partnering with a bike-sharing enterprise. Or it could subsidize its canteen to ensure that healthy, delicious food becomes the default option. At Tanita, a Japanese health-equipment maker, the lunch sets typically contain fewer than 500 calories, but are so filling and delicious that the canteen recipe books have sold more than 5.4 million copies. No canteen? In smaller offices, it could be as simple as providing fresh fruit instead of donuts within arm’s reach.

The logic is to make healthy actions easy and enjoyable, and at the same time, unhealthy ones harder and less fun. People will repeat actions to form healthier habits when both conditions are met.

Aside from behavioral repetition, the presence of stable context cues contributes to successful habit learning. People are more likely to floss if they keep the dental floss right next to their toothbrush, which then acts as a cue.

Many studies have been conducted about hand-washing habits. In rural Kenya, it was found that including a mirror in the design of hand-washing stations helped draw users to the installation—who would think that seeing ourselves is a significant reward? It increased repeated use and created a habitual association between hand-washing and grooming. In Bangladeshi primary schools, hand-washing habits shot up from 4 to 74 percent among students after footsteps painted on the floor marked a path from the latrines to the hand-washing stations. By making repetition easy, the schools helped students form the habit of hand-washing.

The idea behind cues is that context matters. About 45 percent of people’s behavior is repeated almost daily and usually in the same context. Firms may take advantage of piggybacking, a powerful form of cue that ties a new healthy behavior to an existing habit. For instance, employees could be encouraged to schedule walking meetings at established meeting times. They could also be trained to recognize signs of stress and given the tools to practice on-the-spot mindfulness.

Rewards play a huge role in successful habit formation. A classic example of this is the piano staircase experiment in Stockholm, which tested whether more people would prefer to use a fun staircase where steps looked and chimed like piano keys, instead of the nearby escalator. Sure enough, 66-percent more people chose to use the “rewarding” staircase.

At du, a Dubai telecom firm, the performance of every top executive includes yearly, personalized wellness targets (e.g., blood glucose, cholesterol, and weight). The company offers its nearly 2,000 employees a large array of fitness activities and facilities, including nine sport clubs and various competitions and challenges, all of which increase the fun factor.

The interesting thing about rewards is that uncertain rewards work best. The global lottery industry, estimated at nearly $300 billion (twice Amazon’s 2016 sales numbers), is largely built on this fact. The success of email and social networking sites also attest to the power of uncertain rewards: People keep checking them even though the content they find is far from always fascinating.

Similarly, behavior change interventions should give rewards at uncertain intervals, but often enough to motivate people to perform the target behaviors. This can be done through gamification, a process whereby a potentially tedious task is made to feel like a fun game. The important point for habit formation is that rewards need to be immediate, not given at the end of a competition. Immediate rewards tie together context and response in memory, making actions automatic.

Breaking unhealthy habits

Research has shown that while forming healthy habits is essential, it’s equally important to break unhealthy ones. We see how our usual behavior is controlled by cues to a significant extent. On the bright side, once the cue to an unhealthy behavior is removed, it provides a window for behavior change. No longer in autopilot mode, people have to make decisions about what to do. That’s when an employer can encourage them to think about their health. When new employees join an organization, many cues are disrupted, from their commute to their desk and lunch arrangements. This disruption makes this group of people especially amenable to starting healthier habits.

Changing the environment helps people root out undesirable habits. The best example of this is how many governments have managed to reduce the number of smokers over the years by gradually increasing smoke-free areas and taxes on cigarettes. They didn’t just share information about tobacco’s health risks and leave it at that. Likewise, firms can make it more difficult for people to indulge in unhealthy habits, by controlling the content of vending machines or banning after-hours work emails, for example.

Vigilant monitoring is the most personal step involved in breaking unhealthy habits. In several studies, participants were better able to curb bad habits, such as eating junk food, if they were instructed to carefully monitor for slips. Employers may help by raising their staff’s awareness of how human behavior is often governed by habits. Of course, this is a short-term solution; most of us don’t have the energy or focus to continually monitor our actions. But it can help get us started on habit change.

Enjoyable healthy habit formation

The biggest reason employees fail to participate in corporate wellness programs is the lack of time. This behooves employers to find ways to make healthy habit formation as seamless and enjoyable as possible, and embed them in their culture. Scientific studies have shown that the most successful interventions are two-pronged: It’s just as important to nudge healthy habits as it is to deter unhealthy ones. Employers who can figure out ways to make healthy habits fun and convenient are those who will reap the biggest rewards of a healthier, more engaged, and more productive workforce.


About The Author

Wendy Wood’s picture

Wendy Wood

Wendy Wood is the Distinguished Visiting Chair of the INSEAD-Sorbonne University Behavioural Lab. She is the provost professor of psychology and business at the University of Southern California.