We started this conversation with redefining wellness. You have said that the true “potential of wellness initiatives can only be realized when wellness is embedded within the organization’s core business strategy (.pdf)."

Q: What do you mean by embedding wellness within a core business strategy?
A: Any organisation should begin the conversation thinking of wellness in the same vein as any other C suite or senior executive concern. A strategic approach allows for executive ownership, builds clear objectives and, importantly, sets long term expectations. Key performance indicators then become a measure of delivery against the strategy rather than an end in themselves, which is how they are often used today.

Q: Why is wellness as a strategy the only way to realize its full potential?
A: Right now, wellness is generally a part of Human Resources’ morale boosting initiatives, corporate responsibility and attempts to do something good for employees. There is no doubt that such an approach does have an impact. In years one and two there is often a decrease in healthcare costs, but the real issues come when organisations try to replicate such improvement for the long term. An approach built on interventions and short term incentives cannot provide the much desired sustainable individual behaviour change. Without a clear link to strategy, programme design builds from the bottom up, without adequate budget security, and becomes dependent on a series of interventions and initiatives. These may, or more often may not, deliver a positive return on investment and miss out on the full potential value that wellness programmes can deliver.

Q: Many employers are providing incentives for participating in wellness programs, following disease management protocols or “living healthy lifestyles.” Other employers are imposing penalties on employees who smoke or refuse to participate in wellness initiatives. What is your view about incentives and penalties as a strategy for wellness?
A: Incentives and penalties are certainly part of that strategy. But not one that I would recommend for long-term sustainable well-being. Many employer mandated wellness programmes have proven to be successful and delivered measurable returns. There are multiple issues that arise, however, in setting the appropriate scene and maintaining the energy and appropriate behaviour change in the long term. Some of the challenges are identified in a recent Human Resources Executive story, Getting Tough.

Penalties (or disincentives) might work in the short term, but generally fear as a motivator will not sustain its goal. People might do something quick to not be ‘assessed’ the penalty at the beginning of a programme, but they haven’t changed. Think of the fad diet many will do before a reunion, wedding, or other major life event. It works in the short term but generally fad diets are just that and they don’t change long term behaviours. Penalties are not going to be assessed daily and certainly, I would not recommend that daily penalties be a part of wellness. It’s a little counter-intuitive and may lead to more stress.

While incentives and positive reinforcement may work in the short term – extrinsic rewards usually or tend to need to get bigger and better. Extrinsic rewards alone will not lead to sustainable change because once those rewards are taken away some may stop participating.

The key is to figure out what will keep employees headed down the right path and how to change the culture enough that these short term incentives are no longer the driving force they were initially. And, then it is a matter of providing a supportive environment and community of shared interests, values, and wellbeing. But, changing the culture and the mindset is the key, and that must be a part of a company’s long term strategic business plan.

Q: Are there roadblocks when the senior leaders themselves are not examples of living healthy?
A: It can make it more challenging, but essentially no. Certainly, health is important and being a champion of wellness to accelerate that change makes it easier when the senior leaders embody health and lead by example. But, wellness is more than just a person’s BMI or whether they smoke and belong to a gym. Senior leaders need to think strategically, provide a vision, and remove road blocks to organisational effectiveness. Senior leaders need to be able to take the same journey as their employees. That’s not to say that they have to be the fittest tri-athlete out there, but certainly prepared to take the same medicine as everyone else.

Q: If a senior level executive wants to implement wellness as a strategy,” what steps do you recommend they take?
A: There is no one recipe we can give to organisations and say “here, follow this.” But, in general here are some things they should consider:

• The first thing that is necessary is the senior leaders must buy into the initiative. Without their buy in, little will change in an organisation’s culture.
• Ensure that wellness objectives are aligned with organisational strategy. So, for example, if the organisation’s strategy is to control costs, then we are going to start looking at the causal factors across the population with the greatest impact on costs. This begins the process of building a clear road map to tackle that which is causing the deficiency in an area of performance.
• To get to the root cause, we will need to measure and assess needs and help identify causal factors impacting wellness and performance. Many times the data gathered by most Health Risk Assessments are not linked to a companies’ strategy and that is often one area of disconnect. We need to look at data in a more sophisticated way.
• Once we have the strategy identified, the cause that is impacting wellness and performance, and what the objectives are, then clear next steps must be communicated. The wellness and strategic objectives must be communicated in various forms across the organisation, consistently, and often to engage stakeholder and wellness champions.
• We will need to generate data for decision-making and then, and only then, design interventions to change individual behaviours that are linked to strategic needs and organisational performance.
• Ongoing reviews and assessments should be done to ensure that the right interventions are being used, the right incentives are needed, and that those continue to align with business strategy.

Q: Where is the starting point to begin this change?
A: Start communicating. Build and share the business case as to why wellness is necessary – that is, figure out the needs of the organisation and what it is trying to achieve. Be specific because “increase profits” is too broad. The ROI argument is often a journey not a destination and is, without really clear measurement, a loose science. Educate others about how to achieve health and engagement. Think about support systems that need to be put in place to embed the change. Reassess for the long term to see if the return on investment is consistent with the company’s goals.

Q & A was conducted by Mendy Mattingly.