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By CYRIL TUOHY, managing editor

... but don't blame the wellness program. Blame the people in the program and how difficult it is to change human behavior.

Fewer still, about 2 percent or 3 percent, are successful over their lifetimes; the statistics are about the same for smoking, she said. Why is it so difficult for wellness programs to alter the habits of workers, Oprah Winfrey included?

It may be because we've spent decades going about changing behavior using the wrong approach, an approach based on incrementalism.

"We've in the past held that behavior change is best handled via incremental changes, but the research shows that the best way is to attack multiple fronts at the same time," said Harnett, who lead a panel discussion on integrated disability management and wellness Thursday, on the occasion of the 17th annual National Workers' Comp and Disability Conference & Expo.

Thus, an obese adult would have to exercise vigorously and eat healthier food every time he opened his mouth. Once people are ready to change their behavior, it's more efficient for the body to apply the new patterns of behavior across different activities, said Harnett.

Companies looking to penalize their employees as an incentive to improve their health don't generally succeed, Harnett also said.

"Penalties work for a short period of time, then people get angry and they go back to their former behaviors," she said.

In addition, the odds are stacked against behavior change, she said. Studies have found that as many as 90 percent of bypass surgery patients will return to habits before surgery because they've survived, she said.

Or take the examples of heart disease, stroke and cancer, all leading causes of death in the United States today. Because patients are surrounded by people who've survived from these threats every day, people generally don't get angry or move to aggressively counter the threats.

"Because you're surrounded by people who've survived this every day, and they take medicine, you don't get outraged about it even though more people die from this than SARS and Mad Cow disease," Harnett said.

Yet the reaction to SARS and Mad Cow disease was swift and far-reaching, even though no one died in the States from SARS.

Or take Sept. 11, 2001. The events of that day took the lives of about 3,000 people, and reaction was swift, the outrage palpable. Yet it bumped up the death rate in the workplace "by only about half a person," she said.

Incentives to improve employee wellness and get workers to change their behavior also work, and incentives work best when companies let employees themselves identify those incentives.

"We're kind of like Pavlov's dogs," said Harnett. "We respond to incentives."

November 20, 2008

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