One of the difficulties of running a health and wellbeing program in the workplace is that it is usually the people least in need of participating – the people who are already fit, healthy and active – who are most keen to get on board. These employees put their hands up time and time again, while those who would benefit most from health interventions are much harder to interest and motivate.

There are many reasons why people are unwilling to participate in health-focused activities. Some of these reasons will be related to physical health, for example if a man is very overweight and lacks agility and aerobic fitness, he may be disinterested in the office’s lunchtime walking group. However, chances are there is also a social and psychological component to his lack of participation.

He may feel embarrassed about his lack of fitness and think that he is incapable of losing weight, or he may be in denial about his own exposure to health risks. If he is to participate, the workplace health and wellbeing program must not only suit his fitness levels, it must also address the thoughts, emotions and behaviours that prevent him from taking part.

According to clinical psychologist Steve Beller of the Curing Healthcare blog, there are four types of employees to consider when planning health and wellbeing programs:

1. Activists – rational, confident and motivated people who “deal with their physical and mental health problems (existing conditions and risks) by using positive, proactive coping strategies;”
2. Wannabes – people who, through a lack of self-confidence and motivation, “talk about improving their health and wellbeing and are willing to learn about healthy living, but never seem to act on it, or do so half-heartedly;”
3. Inactives – pessimistic people, lacking self-confidence and motivation, who “think about their health on occasion, but do not believe they should or can do anything to improve” it; and
4. Ignorers / Deniers – people who do not focus on their health, and who are very difficult to motivate to do so, even when they are ill, injured or obviously at risk of health problems.

Activists may present in the workplace as health champions, or simply as employees who take a sensible, proactive approach to their own health and wellbeing. The latter three groups, however, require specific strategies in order to inspire and empower them, and to assist them face the facts about their own health, or lack thereof.

For Wannabes and Inactives, the most effective way of raising interest in health and wellbeing is by providing them with information about both their own levels of health and simple methods for improving it. This means that health checks – followed by appropriate activities – are a good place to begin.

Employers should be proactive about dealing with the common excuses used to justify a lack of participation in interventions:

• “I’m too busy” / “I have too many family commitments” – Make the program available during work hours.
• “I don’t have the money for it” – Employers should pay for or subsidise the program. Studies suggest that expenditure on health and wellbeing leads to substantial savings in terms of lost time and sick leave (around $3 for every $1 invested).
• “I’m not fit enough” – Care should be taken to ensure that health initiatives are not intimidating to potential participants, for example a walking group may be more suitable than a running group or team sport. Programs should also be advertised in an engaging and inspiring way.

Where resources allow, it may be useful to employ health and wellbeing coaches or counsellors, who can target the underlying reasons for people’s resistance to lifestyle change.

The most difficult group to motivate is the Ignorers / Deniers. Often, these people avoid thinking about their health because if they did it would terrify them! Alternately, there may be social factors that prevent them from getting involved in workplace programs, such as a macho culture that sees illness or help-seeking as weakness. Even when there is serious risk, or evidence of an existing health problem, ignorers / deniers tend to avoid thinking about it, or doing anything to fix it.

One of the best ways of breaking through these barriers is by focusing on the positive consequences of good health, rather than the negative consequences of poor health. Dr Beller suggests that, instead of talking about “fear of dying” (e.g. high cholesterol causes heart disease so you better stop eating chips and a burger for lunch every day), OHS and RTW staff should focus on “joyful living” (e.g. healthy food tastes great and makes you feel even better).

Where a macho culture dominates, it can be useful to reframe the issue. The seeking of help when necessary can be characterised as a “sign of wisdom and personal strength,” while refusing help can be characterised as “childish and self-destructive”.

Levels of participation in health and wellbeing interventions are never just about physical matters, even when the program is targeted at fitness or weight loss. Employers who focus on the health-related thoughts, emotions and behaviours of employees will have a better chance of getting the entire workforce motivated to live and work healthfully.

For more information on activists, wannabes, inactives and ignorers / deniers, check out Steve Beller's Whole-Person Integrated-Care Wellness Solution, online here.