Fernando Akio Mariya1,2
One of the main issues to consider upon implementing health programs is how to engage the targeted workers. While focusing on engagement certainly helps increase the rates of participation, there are other relevant aspects to which occupational physicians should pay attention. Understanding how and why people become motivated and engage in activities is essential to the development and success of programs. In this semi-plenary session, we will review some key-notions relative to motivation and engagement. Within this context, one needs to understand the health needs of the population and their intention to change their lifestyle so that workers can see the advantages of participation and the positive impacts of programs on their health.
The World Health Organization model for this subject is related to a widely acknowledged organizational process of "continuous improvement", which ensures that health, safety and well-being programs will meet the needs of all the interested parties and be sustainable over time. To encourage employers and employees to invest in change, first one has to collect information on the needs, values and priorities of people.
The stages of change model is a way to explain the fact that people undergo several steps when changing their behavior. Understanding that such stages do occur might be helpful to occupational physicians when designing health programs to help the target population along the process. For individuals to move through stages, they need: information on why they need to change; personal reasons to change; more reasons to change than not to change; a positive mindset toward making changes; trust in themselves and in their ability to change; knowledge and skills (or resources) to change; social support and encouragement to change; an environment supportive of change; and implementing change.
In each and every workplace, there will always be some employees more likely to participate than others. Leading workers to a healthier lifestyle is always a success, even when they do not achieve the outcomes which would effectively improve their health. Workers aware of their need to change, but who are not making any attempt in this regard might need help to shift their mindset or to develop the due skills, or receive social or environmental support. Then, one should bear in mind that even when people do change, relapse into older behavior patterns might occur at any time.
People often interrupt their changes of behavior several times before they succeed to maintain a new pattern. Motivation can be intrinsic or extrinsic. Intrinsic motivation refers to the behavior deployed to accomplish a goal considered relevant to the individual themselves. In turn, extrinsic motivation involves a material reward, such as money or awards. In addition to external rewards for short-term achievements, such as money or awards for participating in well-being programs, occupational physicians might also help workers develop their intrinsic motivation to ensure the long-term continuity of lifestyle behaviors.
Communication and marketing might represent the second most important component of health programs, after the development of a culture centered on the well-being of workers. Assessing the workers’ demography is useful before you decide on how to communicate. What media do they use? What media are available and can be used at your company? How much time, money and resources are available to occupational physicians for communication? After having collected this information, occupational physicians can create messages and select the most effective media to reach their audience.
Planning how to communicate and divulgate health programs and all the comprehended activities is important, including who will design materials, who will be necessary to help in the divulgation and when and where things will be available. When companies have a marketing department or there are creative employees, occupational physicians should discuss the communication/marketing plans with them. Health programs should be adjusted to the company’s culture, while having their focus on the employees.
Some aspects which should be taken into account include data confidentiality and privacy, leadership, participation of workers in the design of programs, transparency and feedback aiming at continual improvement. Without ensuring data confidentiality and privacy, it is not possible to collect reliable information within the occupational medicine setting. If information about the health of workers leaks to other departments, the trust in the occupational medicine department will break and the opportunity to determine the workers’ needs will be lost, because they will begin omitting information.
As concerns leadership, efforts should be made to engage the main stakeholders (e.g. upper management, trade union leaders) in the integration of the concept of healthy work environment into the company’s business goals and values. Providing evidence of such commitment is important, for instance, through documents describing broadly encompassing policies preferentially signed by the highest management authority and clearly stating that the initiatives to promote a healthy working environment are part of the organizations’ business strategies. Workers and their representativeness should not merely be “consulted” or “informed,” but must actively participate in each step of risk assessment and process management, from planning to evaluation, and their opinions and ideas should be taken into consideration. Ensuring that employees have collective means of expression is essential.
Health programs should inspire workers to live well. This goal demands a unified approach to occupational health and well-being programs, which helps in the management of the workers and their families’ health, as well as of the long-term health of the business. Workers should be assured they will be able to find simple information and easy access to everything they need, from healthy recipes to well-being programs and activities in the workplace. Programs should consider the following global well-being enhancing factors: social connectivity, emotional health, financial security and physical health.
1. Burton J. WHO Healthy Workplace Framework and Model: Background and Supporting Lierature and Practices. Available at: https://www.who.int/occupational_health/healthy_workplace_framework.pdf Cited 20 Apr 2019
2. Organização Mundial da Saúde. Ambientes de trabalho saudáveis: um modelo para ação: para empregadores, trabalhadores, formuladores de política e profissionais. Brasília: SESI/DN, 2010.