BJ Fogg of the Stanford Persuasive Tech Lab present Five Secrets of Behavior Change - Hot Triggers to New Habits
A crew of us recently returned from the highly attended Conference Board’s Health Care Employee Conference in San Diego. The event was a who’s who in terms of innovation in wellness, health management, health & productivity and health engagement. High-performing Fortune 500 employers. Leading nationwide consultants. Top providers and vendors in the space. A plethora of topics were a buzz in the keynotes, breakout sessions, and halls of the conference, including ever-so pending health reform updates and implications, progressive incentive program designs, advanced reporting and analytics, and greater transparency of data. All topics worthy of discussion and debate, aimed at creating cost-effective solutions for employers.
Within the sea of noteworthy conversations, RedBrick was proud to sponsor a highly trending topic we believe is the driving force behind the success of employer health, wellness, and increased productivity – Behavior Change. Between our highly successful four-hour pre-conference workshop and our in-conference breakout session (the most highly attended at the event), it’s clear the market is clamoring for thought leadership around what drives healthy habits. Leading our sessions was one of the foremost experts on behavior change, Dr. BJ Fogg, Director of the Stanford Persuasive Tech Lab. He guided attendees through practical application of motivation waves, ability and small steps, and placing hot triggers in the path of those ready to engage.
We also demonstrated a beta version of our latest cutting-edge product innovations and journey-based health-improvement programs, created in concert with Dr. Fogg, and are thrilled to see the enthusiasm from the large employer market. A good sign we’re continuing to take the right steps to further engage employees in their health, create healthier populations, and lower costs.
A recent USA Today article on the use of wellness incentives to drive health engagement has popped-up on numerous industry social media sites this week. The article lays out the rationale, increased usage (54% of employers in 2011) and their effectiveness. On the flip side, critics argue around issue of fairness and discrimination.
Whatever your stance, with well over 50% of healthcare costs attributed to behavior, it’s clear we’re in a system that will run financially amuck without greater engagement of individuals. It’s also clear incentives and rewards will be a tool to help drive that engagement. As our head of Health Strategy, Kurt Cegielski, recently discussed at the Institute for Health and Productivity Management Conference in Orlando, the key is to create a fair rewards system that provides reasonable alternatives for everyone participating and realize incentives are only one lever when engaging consumers. Incentives foster extrinsic motivation, but you need clear communications, pertinent program design and a strong culture of health in the workplace and home to make engagement easy and create intrinsic motivations that drive sustained engagement and behavior change.
More importantly, to combat skyrocketing costs attributed to poor behaviors, we need to create individual accountability. Those who engage in their health pay less while being subsidized by those that do not engage in their health (with everyone given a fair and attainable opportunity to engage). We need to take rewards beyond the mindset of simply being add-on incentives. Rewards are the first step in changing the way we finance healthcare.
It seems like nearly every day there is another survey, study or research paper that arrives at the same alarming conclusion – individuals are at record rates of poor health, with future projections trending downward. Making matters worse, is that even though this epidemic is widely known, there is not currently enough being done to combat it. To address this, an elite group of health & wellness experts and thought leaders recently came together at the first annual Health Management Innovation Summit to conceptualize ways to reverse the downward spiral our society is facing.
Attendees were drawn from a cross-section of the health management industry, including senior level leaders from national consulting firms, employer benefit directors, clinical and behavioral economics academics and consumerism experts. Attendees were honest and forthcoming in their admittance that change is needed to reverse the health pandemic that our country faces. It was agreed that a new approach to making healthy behaviors the norm needs to be implemented to truly improve the health of the American population. To succeed moving forward, all areas of the industry must embrace and infuse fresh and dynamic ideas and approaches that empower the individual to make healthy choices. As one attendee best summed it up, “The status quo reigns supreme, even though it’s not the best choice.”
The health of our society is at an inflection point that a handful of organizations can’t influence by ourselves. The opportunity to have a positive impact on the health of millions of Americans is in reach, but we need the commitment from employers, organizations and most importantly the individuals. Over the next few months, this blog will serve as a channel for communicating and analyzing the ideas and conclusions from the Summit. In addition, attendees of the Summit will be invited to provide their own commentary, insight and thoughts on the topics. From reviewing what has worked and what hasn’t in the past, to looking ahead to what the future holds, the Health Innovation blog will provide the opportunity to have an intimate and candid from some of the most coveted and respected minds on how to make healthy behaviors the new norm.
- Kyle Rolfing, Founder & President, RedBrick Health
If you are like most people, you marked the eclipse of 2011 into 2012 either formulating or contemplating an individual behavior change resolution. It’s annual tradition. Just hours into the bold new year, it also follows tradition the majority of those resolutions have already slipped from our grip or tumbled over the ledge completely. In a cage match of New Year’s resolutions and leftover holiday egg nogg, it’s a close call which is more perishable.
When answering the question – why is the failure rate of desired behavior change so high – the prevailing wisdom has centered on the limited daily allotment of willpower. It’s a supply and demand deal. The prevailing theory has been that our hearts and minds have a finite daily supply of energy necessary to fuel healthy behavioral decisions. Once that supply is depleted, by noon or nine, we are much more prone to fail at temptation resistance and staying on task – our better goals for self improvement the victim.
But new research suggests the fossil fuel theory of willpower is oversimplified. Willpower, it turns out, is a much more renewable energy source than we have ever given it credit. Highlights from research just published from a Stanford School of Medicine psychologist suggest:
- Biology (our physical beings) matter. Better self control is made exponentially more possible when our bodies get the rest, nutrition and repair needed.
- Willpower is trainable. We each increase our own daily supply of motivation and control through muscle memory – exercising the elements of willpower that lead to increased stamina (we’re talking willpower muscle here, not skeletal and cardiac).
- Physical exercise is invaluable – it leads to brain growth, prefrontal cortex transformation that can jolt our willpower with a sustained turbo boost.
- Personalizing motivation and focusing on incremental success along the way of larger goals fortifies future success. Healthy behavior change is a personal journey, not a one-nighter.
What can the innovators of today’s health and wellness solutions learn from this? Behavior change is not a one size fits all, nor is it a one and done (or one and undone) prospect. It requires sustained focus, personalized rewards, and stronger mind-body connective tissue than we formerly believed. It is also a skill and power than can be enabled, harnessed and supported. This is exciting news for those of us in the behavioral change industry – insight that can exponentially increase the success rate of the graduating class of New Year’s Resolutions 2013.
It is credited for 26% of heart attacks and 12-19% of strokes and a devastating 443,000 annual premature deaths and nearly $200 billion in U.S. healthcare and productivity costs. And the good news is the majority of individuals addicted to its unnecessary place in their lives desire to give it up. That’s the analysis a CDC study released a few weeks ago concludes – of all adult smokers in the U.S., 70% want to stop and more than half (52.4%) have made an attempt to do so in the past year. The bad news is the percentage of those who achieve cessation consistently falters in the low single digits.
Behavior change theories place considerable weight on the power of self motivation for good reason – the first phase of sustainable behavior change is almost always consumed by a strong self-regulatory and goal setting phase (intrinsic motivation.) When it comes to smoking, you can already place a fat check mark in that important first phase. Most of today’s smokers want to quit and are already motivated to do so, even before their employer might provide them with further financial incentives to sweeten the deal. It is the goal pursuit phase that needs help.
Here’s where the new CDC analysis illuminates why so many would-be ex-smokers remain entangled in smoke. Of those attempting to quit, less than half receive physician encouragement to do so and only one-third seek counseling and/or medications when they try to quit. A study out of the United Kingdom earlier this year provides even more enlightening information. In a randomized study of nearly 6,000 smokers who desired to quit, those who were provided ongoing messaging to quit achieved 6 months abstinence success more than twice those who did not receive this messaging (10.7% vs. 4.9%). Ongoing feedback and messaging works – it can provide the difference between desire and achievement.
The rewards of tobacco-related behavior change are significant – for individuals, their employers and families. The CDC notes there are related health benefits for any age smoker who succeeds in quitting, but those who quit before age 35 earn mortality rates similar to those who never smoked. There may be no other unhealthy behavior that when turned around can truly offer up as clean a slate for health and health costs. But employers hoping to rid the air of smoke need to extend motivation and support beyond mere financial incentives to do so.
Innovation in health engagement and behavior change is generated by the same fuel mix energizing breakthroughs in other industries – the right scientists in the right lab. That’s why RedBrick Health is excited to announce the addition of several key senior technologists (Gal Bar-or/CTO, Mike Milkovich/Product Development, John Page/Client Operations) to their leadership along with the formation of a Health Management Innovation Lab at its expanded corporate space. It’s a significant investment RedBrick makes as it advances its leadership in consumer health engagement technology, further leveraging mobile and social engagement application development (among others) – making behavior change and better health part of everyday life of the consumer. The investment comes as RedBrick Health doubles its staff in response to 600% two-year membership growth in its healthy behavior change solution.
Exciting times for health engagement innovation. Exciting times for RedBrick Health. Read more.
We’re going to momentarily sidestep what would be a more likely holiday-timed blog entry preaching healthy consumption (e.g., the annual Footloose-inspired dance-off between tryptophan and saturated fats hoofing across the nation’s dining room tables this Thursday) to instead focus on the concept of thankfulness. Counting blessings – perhaps the less traveled road of tradition this week brings.
Were you aware, for instance, 80% of American workers cite the benefits they receive from their employer as one of the reasons they work for that company? That’s a significant nod of appreciation, and it comes to us through the 2011 Mercer Workplace Survey just released. This high indicator of benefit related gratitude comes at an interesting time – when employers are asking their workers to share more of the cost burden of healthcare than ever before. Despite being asked to pay more (and 44% indicate they are), 46% of employees state their health benefits are “definitely worth the cost” (up from 38% one year ago.)
Wow…paying more out-of-pocket AND increasingly appreciative of the benefit? How did that work?
One key offering more and more employees are taking advantage of is workplace wellness programs. Motivated by the additional costs of their health benefits, nearly a third of employees state they are participating in the programs their employer provide to help them adapt healthier behaviors – a participation uptick from 23% a year ago. And nearly twice as many employees are participating in condition management or coaching programs.
It turns out asking employees to be more accountable actually makes them more accountable.
In the meantime, a new Towers Watson survey of talent management indicates employers would be wise not to take for granted the appreciation their employees covet for wellness programs and health benefits in general. Even in this atmosphere of increased unemployment, they find six in ten companies struggling to acquire and retain critical-skill employees. The survey also indicates organizations underestimate the parallel between employee retention challenges with work related stress and work/life imbalance. Again, a well structured wellness and total rewards approach can go a long way in attracting and maintaining healthy (and grateful) employee bases.
There. We safely avoided any preachy advice on keeping a firm wrist with the gravy boat this holiday by focusing instead on the power of gratitude. That’s healthy too, isn’t it?