Starting the 'Fire' Under an Unmotivated Employee
AN employer of any size is always seeking a way to reduce the costs
associated with absenteeism, injuries, worker's compensation claims, insurance
claims, and/or poor morale. With our aging workforce and the natural risks
associated with aging, time and efforts may seem fruitless. However,
Occupational Health & Safety (November 2002) reports the World Health
Organization identified for the first time 10 risk factors contributing to
disease and death (World Health Report 2002-Preventing Risks, Promoting Healthy
Life).
These preventable risk factors "account for about 40 percent of the 56
million deaths worldwide annually and one-third of global loss of healthy life
years." Intervention on a governmental and industrial-led level would have major
benefits.
Given this, the employer adopts a safety/wellness program. The appointed
Safety Officer or Wellness Coordinator is challenged to design a program that
attracts and motivates employees to embrace safe work ethics or take on a
healthy lifestyle of exercising, eating right, and more. Ultimately, a safe and
healthy workforce will reduce high absenteeism, injuries, high worker's comp
claims, and high insurance claims and will increase morale.
However, the best-planned program initially attracts many employees, but once
the novelty wears off, all you are left with are the "worried well" (those
employees who routinely take care of themselves, have few days off, rarely get
injured, or have no need for health care, except for preventive visits) and a
few high-risk employees: the unmotivated employees, or, as I call them, the
"frequent flyers" (those employees who routinely use as many days possible to
take off work, are accident prone, and have not seen a physician for years).
Not all employees will participate because "it's good for them." They'll
participate when they get the right answer for "What's in it for me?" Therefore,
the next step to enticing more "frequent flyer" participation in safety/wellness
activities is for the program coordinator to persuade the CEO to offer
incentives for achievement of specific criteria. Incentives can range from cheap
items like pens or pencils, to T-shirts and sweatshirts or cash. But, again,
your incentive program attracts a few more employees, but the "worried well"
control the majority.
Before you scratch your head too hard trying to figure out why your
well-planned program does not attract and keep all employees, we need to
understand human behavior--more specifically, hierarchy of need, readiness to
change, motivation, and incentives.
Maslow's Hierarchy of Need
Abraham Maslow, a psychologist and
motivation theorist, identified five levels of need or motives to human
behavior. At the bottom of the hierarchy is the strongest need--physiological
needs, then safety needs, belonging needs, esteem needs, and self-actualization
needs. Usually, it is a requirement for each motivator to be satisfied before
the higher need can be fulfilled; however, most practitioners agree these needs
interconnect.
I have heard time and time again from people at the administrative level and
from wellness personnel that employees should participate in wellness
programs because "it's good for them" and "it is the best thing for them." In
essence, this attitude is attracting employees who have already moved through
Maslow's hierarchy of need and are striving to achieve esteem needs or
self-actualization. These employees strive for being their best, rising to their
full potential, achieving inner peace and harmony. You are attracting the exact
population that you already have--the "worried well." The population you have is
one that wants to be its best in all facets of life and is actively doing
something to achieve that.
This way of thinking leaves behind the employee who is striving to meet
his/her basic physiological needs or safety needs. His or her motivation is not
based on who or what he can become, but on putting food on the table or a roof
over his head.
Transtheoretical Model of Stages of Change
Combine Maslow's theory
with the next theory for discussion--Transtheoretical Model of Stages of Change
by James Prochaska. His Transtheoretical Model of Stages of Change identified
six stages of behavior change: precontemplation, contemplation, preparation,
action, maintenance, and termination.
A precontemplator has no intention of changing an unhealthy habit, no
matter what you say or do. Do you remember "You can lead a horse to water but
you can't make him drink"? This is basically the idea of this stage. You can use
any tactic you want to convince the employee that quitting smoking or starting
an exercise program is the best thing for him, but he is not going to
change.
A contemplator intends to change within the next six months. Her
awareness of the risks and benefits of an unhealthy habit has heightened enough
for a change to take place.
An employee in the preparation stage intends to take action within the
next 30 days and has taken some behavioral steps in a positive direction.
The difference between the next two stages, action stage and
maintenance stage, is that the overt behavior has been changed for less
than six months for action and the overt behavior has been changed for more than
six months for maintenance.
Termination means the overt behavior will never return, and there is
complete confidence that relapse will not happen.
Prochaska's model identifies readiness to change. What motivates one person
can be very different for another (Maslow's hierarchy of need). Understanding
what will motivate the "at-risk" employee using the Transtheoretical Model can
be difficult. A practitioner needs to use several different techniques of
motivation to be successful. It is common for a person to move back and forth
through the stages. This can take place for a long period of time until
termination occurs.
Information by means of flyers, paycheck stuffers, self-guided learning
tools, e-mails, home mailings, electronic board messages, and many more needs to
be continual to affect a precontemplator and to reinforce the active decision of
the employee in the preparation stage.
Motivation
B.F. Skinner, a behaviorist, concluded that everything we
do and are is shaped by our experience of punishment and rewards. Today,
incentives or rewards are used to affect the behavior of children. Psychologists
and behaviorists advocate "catching" a child doing good behaviors and rewarding
that behavior instead of correcting an unwanted behavior. By reinforcing a
positive behavior, the child will repeat that good behavior.
Skinner also believed that rewarding parts of the wanted behavior would lead
to the final wanted behavior.
As we get older, we never outgrow the notion of wanting recognition for doing
good things. The incentive/reward may be different but the intent is still
there. Frequency is also standard. This means, to have a wanted behavior
repeated, the initial reward needs to be appropriate and at frequent intervals.
Over time, frequency can decrease because the wanted behavior has become the
norm.
Letting the Theories Work for You
Maslow, Prochaska, and Skinner had
theories pertinent to understanding human behavior. Understanding these theories
will help you with implementing an effective employee program that will focus on
decreasing health care costs, worker's compensation claims, and absenteeism
costs.
Most safety/wellness programs offer incentives or rewards for meeting
specific goals. Many times, however, incentives are given one time per year, and
it takes an employee several months to an entire year to achieve the required
measures. This kind of timeframe can and does lead to injury hiding, cramming to
get points at the last minute, or "fudging" the truth just to get the reward.
The goal is too far out of reach. Which behavior has changed? The purpose of a
safety/wellness program is to elicit positive long-term behavior change not
short-term.
From what you have learned to this point about human behavior, does a reward
given once a year change unwanted ("at-risk") behaviors to wanted behaviors?
Absolutely not! OK, you might have a few, but you do not have enough to justify
your efforts.
Maslow says everyone is motivated by different needs. Prochaska says everyone
is at different readiness levels. And, Skinner says rewarding parts of the whole
will get you the behavior you want. Tell me, does rewarding one time a year fit
into these notions of behavior change? You end up rewarding those who already
behave the way you want because it is not a problem for the "worried well" to
meet the year-long goals. Rewarding once per year is not changing the behaviors
of "high-risk" employees.
Some administrators consider incentives to be bribery. Adult employees are
still human and behavior is a lifelong process, so change can occur at any time.
Remember, behavior change does not stop once you've reached a certain age. At
the work site, behavior is changed with frequent recognition and with positive
reinforcement.
To change an employee's risky behavior to a safe or well one, rewards need to
be frequent and at all levels of readiness. They need to be given for the
slightest hint of a wanted behavior and to an exceeded behavior. They don't need
to be extravagant, but the significance needs to match the behavior and the
employee's wants.
This article originally appeared in the March 2003 issue of Occupational Health & Safety.