by Cynthia Hastings-James, Co-founder, BestLifeRewarded wellness incentive program

About The Author

Cynthia Hastings-James co-founded Cookson James Loyalty Inc. and the launched the BestLifeRewarded wellness incentive platform in 2010. She is an advisory board member for the Health Canada Network on Healthy Eating, a judge for the annual Strategic eHealthcare awards and actively involved in the Kenya Scholarship Fund.

Exploring Opportunities to Leverage our Obsession with Reward Points to Drive Wellness in Canada

“We do not always act in ways that, with hindsight, we most prefer. So, for example, most people would prefer to eat more healthily and to be more physically active than they actually are. Similarly, most smokers would prefer not to be smokers. This gap ... reflects two strong forces: the power of immediate rewards and the automatic cueing of much of our behaviour by environments. Offering a reward can help people to align their actions more closely with their true preferences. From such a perspective, incentives operate to enhance rather than to restrict autonomy.”
Marteau, T., Ashcroft, R., & Oliver, A. (2009). Using financial incentives
To achieve healthy behaviour. British Medical Journal, 238, 983–985.

Most companies recognize the importance of a healthy, engaged and productive team and associated impact on the bottom line. What you may not know is that each of your employees has (on average) 9.2 active loyalty program memberships in their household (Colloquy 2009).

How many of your friends and family members drive $5 out of their way in gas to get $0.03 worth of “bonus” miles? They are not alone. According to a recent Maritz Canada report,1 78% of consumers shop strategically to accumulate points and 35% of people have driven beyond a nearby retailer to get to one where they can earn loyalty points. These incentives drive behaviour.

We live in an era in which chronic health issues are commonplace and increasingly dominate our health care attention and resources with an estimated economic burden of over $80 billion each year.2 By now it’s no secret that Canadians are struggling to maintain a healthy body weight, eat right and get enough physical activity for their health. We also know that Canadian adults who do not meet the recommended levels of physical activity, as set out in Canada’s Physical Activity Guide, are more likely to self-report certain chronic conditions, such as type 2 diabetes, high blood pressure, and obesity, or to report fair/poor general health than Canadians meeting the recommendations.3 Getting Canadians to meet these guidelines would help save $150 million in health care costs annually.

On average, Canadian employees spend about sixty per cent of their waking hours at work. Our workplace environment can have a huge impact on the overall health of employees, yet only 26% of Canadian companies take a strategic approach to improving employee wellness.4 There should be no question that wellness programs produce a positive return on investment. Just Google “ROI Wellness” and you will see over 2.7 million matches... The real question is what are the barriers to implementing fully integrated wellness programs in Canada? Why have so few companies taken advantage of this great opportunity to impact the health of Canadians AND the bottom line? Has it been a cost issue? Lack of resources? No employee interest? Too many fragmented suppliers?

Whatever the reason(s), the great news is that with today’s turnkey technology platforms, there are fewer barriers to entry. Canadian companies have an opportunity to cost-effectively “plug and play” wellness through new integrated solutions. These platforms provide practical education, tools, reminders, tracking apps, “gamification”, e.g. fitness challenges, goal setting, social networking, incentive points and reward redemption logistics.

We all know that sustained employee engagement is critical. In a comprehensive review of the literature on incentives and behaviour change, Sutherland and colleagues5 conclude that “... incentives, even rather small ones, can influence health behaviours,” including both improving patients’ adherence and facilitating voluntary behaviour change. This is especially true when studies for behaviour are incentivized over the longer term rather than for shorter timelines, particularly when long-term outcomes – such as body weight or physiological changes - are being assessed.6

For the behaviour to persist, the incentives either need to be continued, or reinforced through intermittent rewards. Of course, this phenomenon is not exclusive to the use of incentives as an intervention strategy: intervention effects overall for behaviour change are known to decline after the intervention is completed “... suggesting the need for innovative techniques to help participants maintain changes.”7 This conclusion is supported by behavioural economics and learning theory principles that propose our behaviour depends on stimuli or cues that elicit certain responses, and on the rewards that reinforce behaviour. The behaviour may be learned by gradual shaping, and maintenance of the desired behaviour can be facilitated by an environment that elicits responses and provides for immediate rewards rather than waiting for health gains to accrue over the longer term.8 Because practices such as being active, eating healthfully and giving up smoking rarely bestow immediate, inherently enjoyable activities that are intrinsically motivated“9... even highly motivated individuals often have difficulty in making decisions in the short term that favor their long-term interests.”10 Thus, offering rewards or incentives as extrinsic motivators may bridge the time needed to internalize the values and benefits of healthy living.11 The best application of incentives is to use them to attract and engage people through sustained extrinsic rewards, so that they can connect, realize and appreciate their intrinsic motivators to help them sustain lifelong health practices.12

A recent incentive-based flu immunization program on behalf of large Ontario employer included employer on-site promotion, email communication, incentivized online education, email reminders, “bonus” reward points for participation in the clinic and follow-up surveys. It drove a 34% increase in employee immunization vs. the company’s 2010 results with all other aspects being the same (Cookson James Loyalty, 2011). A national program to validate these results is currently underway.

To receive copies of future studies on incentives and workplace wellness, please contact the author or join the LinkedIn group “Health Promotion, Adherence and Loyalty”: http://www.linkedin.com/groups/Health-Promotion-Adherence-Loyalty-3961715?trk=myg_ugrp_ovr

References

http://business.financialpost.com/2012/03/02/canadians-are-down-right-loyal/. Accessed November 20, 2012
http://www.wrha.mb.ca/healthinfo/prohealth/wellness.php. Accessed November 20, 2012
Bryan, S.N., & Katzmarzyk, P.T. (2011). The Association Between Meeting Physical Activity 
Guidelines and Chronic Diseases Among Canadian Adults. Journal of Physical Activity and Health, 
8, 10 -17)
2011 Buffett National Wellness Survey
Sutherland, K., Christianson, J.B., & Leatherman, S. (2008). Impact of targeted financial incentives on personal health behavior: A review of the literature. Medical Care and Research Review, 65, 36S-78S
Johnston, M., & Sniehotta, F. (2010). Financial incentives to change patient behaviour. Journal of Health Services Research and Policy, 15(3), 131-132.
Krebs, P., Prochaska, J.O., & Rossi, J. (2010). A meta-analysis of computer-tailored interventions for health behavior change. Preventive Medicine, 51, 214-221
Marteau, T., Ashcroft, R., & Oliver, A. (2009). Using financial incentives to achieve healthy behaviour. British Medical Journal, 238, 983–985
Ryan, R., Patrick, H., Deci, E., & Williams, G. (2008). Facilitating health behaviour change and its maintenance: Interventions based on Self-Determination Theory. The European Health Psychologist, 10(1), 2-5
Volpp, K.G., Lowenstein, G., Troxel, A.B., Doshi, J., Price, M., Laskin, M., & Kimmel, S.E. (2008). A test of financial incentives to improve warfarin adherence. BMC Health Services Research 8, 272
Volpp, K.G., Lowenstein, G., Troxel, A.B., Doshi, J., Price, M., Laskin, M., & Kimmel, S.E. (2008). A test of financial incentives to improve warfarin adherence. BMC Health Services Research 8, 272)
O’Donnell, M. (2010). Editor’s Notes. American Journal of Health Promotion, 24(4), iv-vi.