don's report archive

by Donald B. Ardell, Ph. D.

Wellness in the Headlines
(Don's Report to the World)

Gilda Radner made "It's always something" a household phrase, a wry expression synonymous with "Oh well." My dad's favorite expression, used when unsure of what to make of a situation, was "that's really something." Whenever I need material for an essay, I open a website or two on worksite wellness. There I can always find news and developments about the latest attempts to motivate employees to take better care of themselves. Often, I find something that evokes an expression along the lines of those used by Gilda and my dad. I know the situation calls for a reasoned reaction, maybe even an essay, but I also recognize that I'll have to ponder the latest innovation before I decide if I like it or not, and why.

Such was the case when I came across an article by Karen Pallarito in Business Week about e-mails and motivation. The gist of the piece was that people are more likely to sustain desired behaviors such as moving more and eating better if messaged to do so on a regular basis. Another way to put it might be, "people will comply with health messages if spammed." No, just kidding—the nature of the reinforcements were nothing like annoying spam. Still, my first response was, "that's really something."

A little more detail on the "behavior change theory" study might be of interest. The e-mail experiment involved 787 Kaiser employees at a facility in California. All subjects completed a diet and physical activity assessment and received feedback on how their habits compared with recommended national guidelines.

Of the group, 351 were randomly assigned to receive weekly e-mails and mid-week reminders with "small step goals" tailored to meet people's individual lifestyles and health goals. Participants were asked to work on one of three paths: increasing physical activity, increasing fruit and vegetable intake or decreasing fat and sugar consumption.

• Participants who most needed to change habits gained the most from the diet of supportive e-mails.
  
  
• The health status outcomes of this approach to health education are still unknown, as the preliminary results cover a period of only four months.
  
  
• The workplace is a favorable environment for e-mail motivation and reinforcement in part because everyone has convenient access to a computer and the support of others engaged in similar health promotion goals.

The U.S. National Center for Health Statistics identifies 33 percent of U.S. adults as overweight, another 34 percent as obese and yet another 6 percent as extremely obese. That's a polite way of noting that 73 percent of Americans are fat—some really, really fat. Only a small segment (I estimate ten percent, at best) of the US population exercises sufficiently, less than 25 percent consume enough fruits and vegetables (five servings daily at least) while 60 percent consume too much saturated fat. What do you think the chances are that a series of e-mails are going to make much difference in these statistics over the long haul? My guess is this: "Almost less than none."

Here is my own theory of why change efforts usually fail. The enemy of behavior change is time, not insufficient reminders to do the sensible thing (s). It takes too much time to exercise, choose and prepare the right foods and do so much else that everyone knows "is good for his/her health." The time factor cuts two ways—the right thing takes too long and the bad consequences of the wrong thing also takes too long—to manifest. As the polymath physician, comic, author and about a dozen other talents and career skills noted when Dick Cavett confronted him on his choosing to smoke, "I know these will kill me. I'm just not convinced that this particular one will kill me."  (Source: Dick Cavett: "Why Can't We All Talk Like This?" - Talk Show, New York Times, May 29, 2009.

The little bump in compliance and other short-term improvements could be explained by a dynamic that social scientists discovered half a century ago—that employees do what you want them to do (within reason) if supervisors pay more attention. This experiment was the famous Hawthorne study wherein productivity got better no matter what the researchers did (paint the walls, change the carpet, etc.) because people want to be noticed and attended, not because wall color, carpet changes and such make much lasting difference. Ditto the e-mail cheerleading in the Kaiser study. A stream of e-mails is not likely to hurt and will almost surely work for a spell, but if real change is desired, REAL wellness education and environments might be greater return investments.

Now that would really and truly be something.

Stay well-and always look on the bright side of life.

(Note: This essay will be filed in the archives in the PHYSICAL DOMAIN under the skill area of nutrition. Additional articles related to this theme may be found there.)

(Ed. Note: Views expressed in this and other columns are those of the author and not necessarily those of the SeekWellness Editorial Board.)

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