I was attending a marketing workshop the other day, and the speaker made a statement that caught my attention. She said, “‘if you build it, they will come’ is not a marketing plan.”

This statement may feel obvious to those of us in the marketing world. However, it turned my mind to employee wellness programs. It reminded me of how wellness program managers who put the most intentionality and resources behind employee health initiatives can still have low engagement. Why are some people showing up to wellness initiatives and others are not?¹

My mind instinctively went to DiClemente and Prochaska’s Transtheoretical Model (TTM) ² and the Stages of Change (SOC).³ This model provides a framework to understand where employees can fall when discussing change management. Initially developed in 1977, the Stages of Change model focuses on health behavior change as an individual process. The stages of the Transtheoretical Model represent different levels of readiness and confidence in regard to behavior change. The model is a true application of “meeting employees where they’re at”. 

 It occurred to me that the intention to welcome all participants or reach the most number of people could be making it harder to meet employees where they are on the spectrum of change readiness. Assessing readiness for change is a crucial element of behavior change and can have a drastic impact on health program outcomes.⁴ 

Assessing a person or group’s likelihood to change is essential to receiving a meaningful ROI on wellness programming. If we’re providing programs that attempt to persuade employees to make a health change when they are not aware that a problem exists in the first place, we are likely to have low engagement. Essentially, if the program offered doesn’t align with the problem employees perceive, it’s not going to resonate with them.

For example, say an organization has primarily sedentary jobs. The employee wellness manager knows that extended sedentary behavior is linked with an increased risk of chronic disease. They decide to provide a lunchtime exercise opportunity for the staff. However, they have several employees who don’t understand the link between a sedentary lifestyle and risk of chronic disease, and some who don’t want to exercise. These employees aren’t likely to come to the program. In order to meet the team members (who are likely in Pre-contemplation) where they are, other strategies will need to be implemented. One method could be to provide a lunch and learn opportunity surrounding ways to use exercise to boost energy and mood while reducing chronic disease. This helps connect employees with the information. Additionally, this will get them thinking about lifestyle choices while providing them with an incentive to listen.

Here at Pack Health, assessing readiness to change and where a member falls in the Stages of Change is clearly defined in the onboarding process of a member’s journey. I talked with Health Advisor Recruitment Manager, Walker Cole, MPH, NBC-HWC to dive deeper into his application of the Transtheoretical Model: “We use wellness assessments to measure their readiness for change. Additionally, when engaging with the member, I’ll ask scaling questions surrounding readiness to change and self-efficacy. Based on their responses, coupled with the results of their assessment, I can get a clearer picture of where they fall within the Stages of Change.”

Understanding an employee’s personal health goals and where they fall in the SOC should determine how to engage that individual. Walker speaks more about his process on this: “If a member is in Pre-contemplation I know I need to educate with humility and without judgment. Comparatively, an employee in Contemplation needs more engagement in the “why” of behavior change. I’m going to take the time to understand their motivations behind making the change. This is where most of our members are. We have to figure out why losing weight is important to them. Then, we can plan for strategies to succeed.”

The 2017 Best Practices in Health Care Employer Survey reported that while 56% of employers believe their well-being programs have encouraged employees to live a healthier lifestyle, only 32% of employees agree.⁵ Not every wellness initiative is going to be a top-level success. Continuing to move the needle to more individualized, employee-focused health initiatives is a good first step to getting employers and their team on the same page.

When asking Walker how he knows if he’s missing the mark, he said: “I get a sense that I’m missing the mark with a member when they are continuously not reaching their milestones or start to disengage. For example, let’s say Betty comes up with the same goal for three weeks. However, she never truly gives it her all. I can see then that she is still in contemplation, and potentially not ready to be in the action stage. That means we need to spend more time aligning her goals and values. We’ll focus on digging deeper into her motivation. That way, we can break down the barriers between her and her goal.”

Every individual is going to have a different story, leading to different barriers and motivations affecting their readiness to change. We don’t expect all employees to work, manage, or communicate the same way, so why would we expect each individual to make health changes at the same rate? By assessing where team members are within the SOC, we can work to make wellness programs more intentional.

Digital health coaching is just one tool in your toolbox. It provides a way to assess change readiness, while also integrating social support. Other tools are easy to implement in-house and can be used to assess change readiness. The University of Rhode Island Change Assessment is a 32-question survey used to measure where respondents fall within the Stages of Change.⁶ Additionally, online tools, such as the Leo App in-office communication tool, Slack, send out regular, randomized employee wellness-focused questions.⁷ This can be used to consistently assess employees through different points in time.

Integrating more customized strategies to assess change readiness is likely to benefit the entire organization. Providing opportunities for employees to feel heard and understood is shown to drive more engagement. Employee wellness programming is no exception to this.

Article updated 4/27/2023

Article written by Brittney Vigna, MPH, CHES, CPH, Marketing Manger

• WHITE PAPER DOWNLOAD: Engaging the Right People: Leveraging the “How” and “Who” of Employee Engagement
• Using Brand Recognition to Foster Employee Wellness Engagement