Creating the Culture of Wellness


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WWCMA January 2012 Event: Creating the Culture of Wellness. This presentation explains the history of the culture-based approach and why a supportive culture is important. It also defines culture and its dimensions.

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  • The methods we are using were first developed to assist Coca-Cola when they bought Minute Maid Orange Juice and became the largest employer of migrant workers in the United States. Coke realized that it needed a healthy culture to improve the conditions of migrant workers. A first issue of the American Journal of Health Promotion came out in 1986. It included an article about the project with Minute Maid. A book, called the Quiet Revolution also talked about this early wellness program. As can be seen in the slide, great strides were made in creating a healthier culture at Minute Maid. The project resulted in great business, health and human relations outcomes. It was a quiet revolution in that the workers and company collaborated peacefully to create a much healthier and more productive work environment. The culture-based approach was subsequently applied at Johnson & Johnson and Hoffmann La Roche. These companies were among the first to offer wellness at the worksite. Since that time more than 1,000 companies, government agencies and educational institutions have used the culture-based approach to advance their wellness programs. More information, including a client list, is available at
  • Show your data from the Lifegain Wellness Culture Survey about recent lifestyle change attempts This is great wellness news. The vast majority of employees are so convinced that wellness is important that they have recently tried to improve their health habits.
  • Show your data from the Lifegain Wellness Culture Survey about lifestyle change intentions. Once again, the coach should acknowledge the high level of interest in healthy lifestyles. He or she may also want to call attention to those lifestyle goals that are most popular. Efforts should be made to assist these employees in achieving their goals. This could come in the form of wellness coaching, support groups, peer coaching and educational programs. Ideally, changes to the environment would be made that would make it easier to achieve and maintain desired lifestyle practices. The coach could lead a discussion of the primary lifestyle change goals and what can be done to support employees’ lifestyle improvement efforts.
  • Most employees are not fully successful in achieving their lifestyle goals. Follow-up interviews usually determine that moderate success is reported when people only achieve temporary or intermittent lifestyle change. Losing 10 pounds out of a goal of losing 20 pounds is one example of moderate success. The more likely scenario is that 10 pounds were lost, but came back.The coach should point out that one of the reasons we are so interested in a wellness culture is to help employees avoid developing new unhealthy behaviors. It is very hard to change unhealthy practices. We want to stop the flow towards unhealthy practices such as overeating and becoming unfit. It is a good idea to create a culture where few employees will find themselves in need of addressing new lifestyle risks. Helping 50% of employees be "Very Successful" is an ambitious and necessary goal. Such a high success rate will greatly enhance peoples’ enthusiasm for wellness. It will also mean a dramatic improvement in other performance measures such as the program’s return on investment.The coach should point out that we must work to create conditions for success. This would mean greatly reducing real and perceived barriers to maintaining healthy lifestyles.
  • We can joke about the fate of our lifestyle improvement efforts. This relieves some of the tension and lightens our spirits. However, we do have to solve this problem if we are going to be successful with our wellness programs.We owe it to our employees not to set themselves up for failure. We need to create conditions whereby most people will be able to succeed. Such conditions include the creation of a culture that supports healthy lifestyle choices.Group Exercise SuggestionThe coach can reinforce the lesson by asking those in the audience to indicate if they had attempted a lifestyle change in the prior year. The coach can then acknowledge that although this is a select group, a very similar high level of lifestyle change attempts is seen in other groups. The coach can continue the lesson by stating that he or she tries to avoid embarrassing people by asking the follow-up question about lifestyle change success. Unfortunately, fewer than 20 percent of most groups report that they were fully successful in maintaining their desired lifestyle change for more than a few months.
  • In any workgroup there is likely to be a range of attitudes towards wellness. Some people will be wildly enthusiastic about efforts to support healthy lifestyles. Some of these will already be involved in promoting wellness. Other people will be on the fence and have other priorities. Still other employees will be uncomfortable with the idea of a workplace wellness initiative. A small group will be vocal in in their opposition. The best strategy for culture change is to shift attitudes one ring closer to the wellness champion position. Try not to antagonize the vocal opposition. We just want this group to become less active in their efforts to stop the wellness initiative. Your best opportunities can probably be found with inactive supporters. See if you can find a role for these people as they are already convinced that wellness is a good idea.
  • When planning a culture-change initiative, it is helpful to establish priority norm goals. Changing norms is challenging and requires a considerable amount of focus. Once the new healthy norm has been established attention can turn to a new set of norm goals.  The selection of norm goals is an important leadership responsibility. There are many behaviors worthy of attention.
  • This picture shows the entrance to a company that purchased bikes for commuting employees. Each month they bring in a bike mechanic who provides free repairs.
  • This picture shows employees in a company that recognized that messages would help with stress and repetitive physical tasks. They hired massage therapist to come in everyday.
  • This picture shows a company parking lot. Employees reported that healthy foods were hard to come by in the neighborhoods. The company invited local farmers to set up farm stands in their parking lot.
  • In the 1990s, Dr. Dean Ornish analyzed more than 100 studies that demonstrated the importance of culture and human relationships. The evidence for the power of supportive cultural environments in health is very strong and dates back to the first studies of life-expectancy and lifestyle conducted in Alameda County California during the 1970s.
  • Relationships and culture also play a key role in productivity. Don Cohen and Laurence Prusak examined the research literature and documented the many ways our social connections enhance job performance and other important business outcomes.
  • There has been a lot of research on the healthiest and happiest places. The good news is that in these places people tend to live a lot longer in good health. These people also seem to be a lot happier than most people. They enjoy a full life. They benefit from living in a culture where the healthy lifestyles are part of the culture. We don’t want or need to move to these distant lands. Instead, we can create healthy and productive environments right here.
  • Creating the Culture of Wellness

    1. 1. Creating the Culture of Wellness
    2. 2. The culture-based approach has a thirty-year track record of delivering outstanding results. Productivity Worker increased income 200% tripled Turnover Racism dropped by was 25% overcome
    3. 3. Recent Culture and Leadership FindingsOf 303 organizations that completed the U.S. based HealthManagement Research Organization’s Scorecard by Juneof 2010, just 25% reported that their senior leadership andculture were “very supportive” of their employee healthmanagement strategy. 66% of organizations with strong leadership and cultural support reported improvements in health risks, compared with only 26% of organizations with little or no support. 50% of organizations with strong leadership and cultural support reported a net positive impact on medical trend, versus only 14% of organizations with little or no support.See for further information
    4. 4. A Wellness Culture Means that SocialNetworks Support Healthy LifestylesFor better and for worse health behaviors spreadfrom person to person. The behaviors investigatedso far are: Healthy Smoking Eating Physical Alcohol Activity Abuse HappinessSource: Framingham Heart Health Study 1971 – 2007 of 4,439 friends, familyand neighbors sited in Connected: The Surprising Power of Our SocialNetworks and How They Shape Our Lives by Nicholas A. Christakis andJames H. Fowler, New York: Little, Brown and Company, 2009.
    5. 5. A Wellness Culture Makes Wellness Programs Work• A culture reaches thehard-to-reach• A culture of healthmaintains healthybehavior• A culture of healthincreases lifestyle-change success
    6. 6. Employees Are Attempting Lifestyle Change Last Year’s Goals Attempted at Least One Goal54% Lose weight50% Eat healthier44% Increase physical activity No 18%22% Manage stress18% Improve social relationships5% Stop smoking2% Address alcohol or other drug abuse problems Yes 82%14% Other lifestyle goal
    7. 7. Employees Plan to Attempt Lifestyle Change Next Year’s Goals Planning to Pursue at Least One Lifestyle Change Goal56% Eat healthier54% Lose weight No 16%45% Increase physical activity25% Manage stress18% Improve social relationships5% Stop smoking2% Address alcohol or other drug Yes 84% abuse problems14% Other lifestyle goal
    8. 8. Few Lifestyle Goals are Fully Achieved Very Successful 16% Not Successful 21% Moderately Successful 63%
    9. 9. Each year, the vast majority of peopleattempt wellness goals. Few succeed.
    10. 10. Cultivating Healthy Behavior Norms Shared Touch Values Points Behavior Choices Peer Climate Support
    11. 11. Cultural ValuesIn a wellness culture,having healthy peopleis a top-tier priority.
    12. 12. Attitudes Towards Wellness
    13. 13. Wellness Value Proposition – Saving lives and reducing illness – Increasing productivity – Controlling disability/illness care costs – Making our organization more attractive to employees and customers – Raising organizational pride and spirit – Caring for the health of our children – Staying true to our history of being a strong and caring organization – A healthy way to compete
    14. 14. Cultural NormsIn a wellness culture,healthy lifestyles are“the way we do thingsaround here.”
    15. 15. Healthy Lifestyle Norms Be physically Eat a healthy Be safe active diet Avoid Socialize withtobacco, alcohol Use preventive friends and and other drug medicine family abuseSleep at least 7 Practice stress Maintain a hours per day management healthy weight
    16. 16. Cultural Touch PointsIn a wellness culture,formal and informalpolicies and proceduresmake the healthy choicethe easy choice.
    17. 17. Cultural Touch Points1. Modeling2. Rewards and Recognition3. Push-back4. Recruitment and Selection5. First Impressions and Orientation6. Learning and Training7. Traditions and Symbols8. Communication9. Relationship Development10. Resource Commitment
    18. 18. Free Transportation
    19. 19. A Real Break
    20. 20. A Farmer’s Market at the Worksite
    21. 21. Peer SupportIn a wellness culture,people effectivelysupport each other inachieving their lifestylegoals.
    22. 22. Health and Wellness Programs That Foster Peer Support Team sports Support groups Wellness mentor, peer Group participation support and wellness games and challenges buddy initiatives Open enrollment to Educational content family and self-help programs members, housemates that recommend peer and/or friends involvement
    23. 23. Cultural ClimateIn a wellness culture,people work and playwell together.
    24. 24. ClimateSense of Community
    25. 25. Relationships Enhance WellnessOur social connectionsare important inaddressing morbidity,mortality, recoveryfrom illness and qualityof life.
    26. 26. A Good Climate Enhances Business OutcomesGood relationships enhancebusiness outcomes by:• Increasing knowledge sharing• Increasing thoughtful action• Lowering transaction costs• Lowering employment costs
    27. 27. Systematic and Systemic Change• What steps are required in orderSustainability PHASE IPreparation Involvement PHASE II Integration to PHASE III PHASE IV plan and design? Analysis Set Objectives Develop Leaders Align Cultural Touch Points Evaluate Introduce the Progress Vision of the New Culture to Celebrate Success All Levels Renew and Extend
    28. 28. Leadership Skills forCreating a Wellness Culture Share the Serve as wellness role models vision Align Monitor cultural progress touch and points celebrate success
    29. 29. Peer Support Skills for Health Help with… Establishing Trust Setting Goals Identifying Role Models Eliminating Barriers to Change Locating Supportive Environments Working Through Relapse Celebrating Success
    30. 30. Supporting Household Wellness Champions Create a Align shared cultural wellness touch vision points Mobilize Strengthen peer the cultural support climate
    31. 31. Wellness Culture CoachingWellness Culture Coaching Skills• Making the case for wellness cultures• Conducting quantitative and qualitative culture analysis• Developing wellness leadership• Mobilizing peer support• Mobilizing household and family support• Integrating culture change into individual coaching and wellness program design
    32. 32. Together We Can Create Own Wellness ZonesThere are places wherepeople live happier, healthierand longer lives:• In Sardinia, Italy• In Okinawa, Japan• In Loma Linda, USA• In Nicoya, Costa Rica