A Map for Organizational Wellness

By Tim Sullivan

Changing workplace wellness is similar to the steps an individual goes through in order to free themselves of an addiction.  Psychologist  James O. Prochaska, PhD., at the University of Rhode Island and some of his colleagues have developed something called the Transtheoretical Model of Behavioral Change (TTM), which outlines the steps people take in their efforts to change behavior.  TTM is generally applied to individuals from a psychoanalytical perspective mainly dealing in cases of addictions or depression.  The TTM applies pretty closely to the steps that a business or organization goes through in developing or augmenting a wellness program.

Six Steps of TTM:

  1. Precontemplation
  2. Contemplation
  3. Preparation
  4. Action
  5. Maintenance
  6. Termination

Precontemplation- Both individuals and organizations fail to see that there is a problem.  The organization probably doesn’t realize that wellness is affecting their staff one way or the other.  Wellness programs might consist of minimal efforts like gym reimbursements and health and wellness emails from an insurance company, or a low priced wellness provider.  If action is identified at all, the time table is probably 6-9 months away.  Getting the organization beyond this stage is vitally important to turning around the ill effects of diminishing health and wellness.

Contemplation- The individual is feeling the effects of their behavior in a negative way.  The concerns are rising to the point of seriously considering the options in dealing with the affliction.  In the business, management might be noticing rising health insurance costs, or has noticed delays in projects on account of a rising absenteeism.   The identified wellness concerns are deemed important enough to require action within 6 months.  More serious attention is spent of finding vendors, addressing areas of potential need, and determining the best forms of motivation for employees.

Preparation- Individuals and businesses both finalize their plans for action within the next month.  Individuals prepare for details of rehabilitation, and organizations work to establish metrics for measuring wellness, so that Return on Investment (ROI) calculations can be better measured.

Action- The program is kicked off.  Individuals commit themselves to breaking their habits, and the organization has rolled out the wellness program.  Employees are engaged in various levels of programs promoting more exercise, better diet, stress relief, and habits control.  This period should be the period where the greatest changes occur, if the program is properly set up and supported.  ROI should begin to show the results of the program in terms of group participation and satisfaction, improvements in biometric data collected, reduction in absenteeism rates due to illness, not to mention improvements in group morale and perhaps productivity and employee retention rates.

Maintenance- After the initial “Action” stage has subsided, the hope is that lifestyles will have changed in a sustainable manner.  If the goals have been reached, the program should enter a period that allows the program to be scaled back without serious changes in wellness. Assuring the sustainability of the progress attained is probably the most important part of the program.

Termination- The final stage according to TTM is termination; because the program has been successful and people are no longer tempted by the poor habits that plagued them prior to the wellness program, it can end.  For individuals, termination without relapses is possible.  In a workplace wellness environment, achieving sustainable health and wellness for an entire group of people is unlikely.  It is probably naïve to assume that any group of people could evolve (behaviorally) to the point that they ALL would no longer need wellness reminders to stay on a healthy path of good diet, exercise and restraint in habits.

In a workplace wellness environment, Maintenance should realistically be the final step.

Throughout these steps it is important that the organization support the wellness program at each step of the process in order to achieve the best results. It is also crucial for the organization to develop metrics by which they can measure the relative success of their program; this allows the organization to make changes in wellness service providers during the Action or Maintenance phases.

It is wise for businesses to engage in some sort of wellness program, as profitability and productivity are tied to the level of health and wellness of the organizations’ employees.  All other things being equal; productivity drops with a decrease in wellness, but productivity rises as wellness improves!

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