Early Intervention At Work: Supporting Employee Self-Care

As one of the most significant public health challenges of our time, preventable health conditions continue to drive unprecedentedly high rates of injuries, missed work days, and premature deaths—yet the CDC reports that Americans are only using preventive services at about half the recommended rate.

Why are these services not being utilized? The problem is often framed using the language of self-determination, in which it is implied that these statistics are the collective result of individuals failing to act in their own best interest. But it is impossible to mitigate such a disparity without addressing reactivity: an approach to health found not only in individual attitudes, but reflected systematically throughout the social circles, workplaces, and institutions that surround us.

As an individual, reactivity is “knowing” you should seek medical attention, but still waiting to go to the doctor until your symptoms have become too severe to ignore. As a business, reactivity is having to shoulder the direct and indirect costs of at-risk behavior that could have been addressed long before culminating into a work-related injury.

For the last 15 years, our company has been committed to reversing the reactivity in this healthcare system and understanding the challenges facing not only our clients, but their employees. Here are the greatest barriers to health proactivity we’ve observed, along with the best practices in early intervention we’ve used to overcome them.

 How did we get here?

Poor awareness of existing resources

Many do not understand the availability of preventative services due to poor communication, on the part of both health care providers and employers.  For example, a company offers free gym memberships to employees, but only about 15 percent of those eligible end up actually utilizing them.

The problem isn’t necessarily a lack of resources; it’s a lack of communication surrounding the availability of these resources. Only 31% of employees feel their employer has effectively connected with them in regard to health, which indicates that employers need to create more opportunities for intervention. Simply having these resources is not enough; employers should be consistently promoting and educating the workforce on how they can take advantage of what’s already being offered to them.

Accessibility challenges

Inconvenient locations, long wait times, unanticipated charges: the American healthcare system, in all its complexity, can be incredibly frustrating to navigate as a consumer.

Since the U.S. remains an outlier in the developed world in terms of health care accessibility, high deductibles and out-of-pocket costs are significant obstacles. Millions of adults are uninsured or underinsured, and do not have the means to prioritize preventative care over immediate needs such as transportation, food, or housing. A recent Commonwealth Fund survey found that one-third of U.S. adults go without necessary health care due to costs; since 2009, employers’ share of premium costs has increased nearly 32%, more than double the rate of inflation.

Consider also that the accessibility issue encompasses more than quantifiable costs. Although some companies do offer financial incentives as an attempt to encourage healthcare utilization, the remaining logistical barriers often render this sort of promotion useless. Take the example of employer-subsidized gym memberships: employees must still bear the cost of fuel or transportation required to get to the gym, not to mention the valuable time outside of working hours that may have already been designated for household responsibilities, childcare, or even a second job.

Proactivity in occupational health

At the core of a truly proactive approach is a conscious effort to meet employees where they are rather than creating hoops for them to jump through. Behind our success in helping companies make a lasting shift from reactivity to proactivity are the key program elements of access, support, and ongoing education.

Improve access by creating opportunities for early intervention

Experts agree that the workplace setting carries enormous potential for facilitating positive behavioral change. Placing a source of preventive care within the building—and ensuring accessibility during work hours—overcomes these barriers by bringing resources directly to employees. A 2014 study with over a quarter-million participants found that adults with the highest rates of physical inactivity, poor nutrition, tobacco and alcohol consumption were also the least likely to seek out primary healthcare. Researchers concluded that interventions in “non-primary healthcare settings”, such as the workplace, were critical toward reaching these individuals.

This is precisely the reason that we have always steered clear of the traditional “on-site clinical” approach of setting up a room and waiting for employees to come to us. Instead, proactively engaging these individuals and bringing preventive health directly to them has allowed us to identify at-risk behaviors or health conditions that may have otherwise gone unmitigated.

Support employees through individual and group engagement

The on-site component is further reinforced with strategic outreach and support; creating an environment that provides both the means and knowledge that employees need to become proactive regarding their own well-being. Not only do health-conscious employees experience fewer injuries and illnesses, they also recover from them more rapidly than their peers. A one-size-fits-all approach to health promotion cannot fully account for the natural variance in individual intention and motivation. On-site early intervention programs allow medical professionals to facilitate on-on-one communication of individual health concerns and needs, while providing support and guidance whenever possible.

Use evidence-based strategies to deliver more impactful education

Tell me, I’ll forget. Show me, I’ll remember. Involve me, I’ll understand.

Even the most well-meaning efforts to improve health awareness in the workplace will fall flat if delivered via information overload. Although it is well established that physical activity helps increase muscle strength, mitigate chronic disease, and improve longevity, spouting off these benefits is not adequate motivation for someone with a sedentary lifestyle to start going to the gym. That’s where organizational change theory comes into play—the insights we have into human behavior are directly applicable to health promotion.

Decades of behavioral science research have shown us that perceived control—the belief in one’s own ability to perform a certain behavior—is the strongest predictor of whether or not someone ends up changing their behavior. The best way to help employees progress from “I should take better care of myself” to “I am and will continue to take better care of myself” is to make their goals as personalized, specific, and actionable as possible. Health and safety interventions that “stick” incorporate the elements of action, target, context, and time.

Take, for example, an employee in a sedentary office environment who would like to achieve a healthier weight. Instead of simply providing the broad objective of increasing physical activity, it would be considerably more effective to suggest they “create an opportunity to walk more by taking the stairs instead of the elevator to your office three days each week”, wherein walking more is the target, using the stairs is the action, around the office building is the context, and three days per week is the time. This sort of specificity helps employees perceive behavioral change as more attainable and less demanding of effort than vague and unhelpful suggestions to “get more exercise”.

Ultimately, employees who perceive that their employer is genuinely invested in their well-being are more empowered to prioritize their own self-care. Regardless of the nature of the work itself, any organization’s journey to improving safety culture must begin with an understanding of the obstacles that face their employees—on a human level.