Mental and physical health are not just important to employee quality of life and wellbeing, they affect the bottom line of your business. According to the APEC health working group the cumulative global impact of mental illness alone in terms of lost economic output between 2011 and 2030 will amount to 16.3 trillion USD. And a recent meta-analysis of hundreds of studies and thousands of business units shows a strong positive correlation between employee wellbeing and firm performance. Hence, it is paramount that we create workplace wellbeing programs that support our employees, improving their physical and mental wellbeing.
But creating a strong and effective workplace wellbeing program is not a simple task. Each organization has a unique team of employees, work environment, and resources. It takes planning and a willingness to change, to create a strong program. To help with this important task, we created the practitioner’s guide to workplace wellbeing programs.
For this post, we will focus on how to effectively design a workplace wellbeing problem that matches with the strengths and needs of your employees using the “intervention mapping procedure.” We will focus on four important steps to guide you from the understanding your employees’ needs to implementing a successful wellbeing program. Specifically we will explain how to:
- Conduct a needs assessment (i.e., figure out what your employees need)
- Develop program objectives (i.e., decide your desired goals)
- Develop theoretical methods and practical strategies (i.e., determine how you will achieve your goals)
- Design the workplace wellbeing program (i.e., implement it successfully)
As always, this post is based on over 30 research studies on workplace wellbeing, intervention mapping, and organization change, drawn from the fields of Industrial and Organizational psychology.
Intervention mapping procedure
Intervention mapping is designed to help planners develop and implement successful health programs. It aims to ensure program leaders adequately research, plan, and involve stakeholders to ensure programs meet the needs of their specific population.
The benefit of the intervention mapping approach is that it takes into account the idiosyncratic nature of users–meaning you can apply it to nearly every organization and every problem.
In terms of workplace wellbeing programs, this approach has been used successfully for targeting employee presenteeism, stress-based mental disorders, work disability, and return to work programs for employees suffering from breast cancer, and lower back pain, to list a few.
As the goal of this post is to create a workplace wellbeing program, we will focus on four of the six basic steps in intervention mapping. (We’ll cover the other two steps–planning for sustainability and evaluating your program–in another post.)
- Conducting a needs assessment (identify what needs to be changed and for whom)
- Develop program objectives (i.e., what do you want to change/do)
- Develop your strategies (i.e the steps you have to take to reach your goal)
- Integrate methods and the practical applications into an organized program
As the goal of this post lies in creating a workplace wellbeing program, we will be focusing on the first four steps.
Step 1. Conduct a needs assessment
While it may be easy to look for cookie cutter solutions online, chances are that they will not solve the problem that is specific to your organization. Regardless if you already have a wellbeing topic (e.g. tackling presenteeism, or absenteeism) in mind or not, if we want to develop a strong workplace wellbeing program, we always need to start with the needs of our employees.
A good place to start is by looking at any data and information you already have that can give clues about the your employees’ mental and physical health–demographic information, reasons and duration of short-term and long-term disability claims, reasons and duration of absenteeism, changes in productivity, common complaints, and so forth.
Next, supplement this data with employee wellbeing assessments. A wellbeing survey can ensure your data is up-to-date and uncover new information and trends. Employees may be more forthcoming with information if such surveys are completed anonymously. Some examples of research-based wellbeing surveys and assessments that you can use are:
- The Work Productivity and Impairment Questionnaire (a survey that measures how specific health problems impair work productivity),
- the Maslach Burnout Inventory, (which measures emotional exhaustion, depersonalization, and accomplishment) and
- PsychologyCompass’ Cognition Coach app (which measures numerous common issues like anxiety, resilience, and sleep. This app also allows organizations to monitor progress using a dashboard, summarizing user statistics to provide valuable team insight over time).
Finally, consider setting up group discussion sessions to discuss common concerns with your employees and intervention team. If you already have a topic that you want to work on, try to obtain feedback on:
- What are the challenges or shortcomings of the existing workplace wellbeing program (if one already exists)?
- What are the important health issues impacting your wellbeing topic (e.g. presenteeism)?
- What jobs/individuals are at risk for your wellbeing topic?
- What are important individual and environmental risk factors impacting your wellbeing topic–like work culture, rules, management, or anything else in the work environment that influences the employee?
Otherwise, try to determine:
- What important health issues are most prevalent in the workplace?
- What jobs/individuals are at risk?
- What are important individual and environmental risk factors that are likely to cause this –like work culture, rules, management, or anything else in the work environment that influences the employee?
- What workplace wellbeing program will the employees benefit most from?
Step 2. Develop program objectives (i.e., what do you want to change/do)
Once you have a solid understanding of employee needs, pinpoint potential barriers and facilitators for meeting them. Identify each important stakeholder, each specific wellness issue you want to address, and how they relate to the changes you want to make (i.e. objectives).
Start with making a list of all the important stakeholders. For instance, if your objective is to tackle presenteeism (i.e., being at work physically but not productively engaged in work) , important stakeholders might include:
- The employee
- Co-workers
- Managers and supervisors
- Senior management/Organization
- Spouse/partner/other family members
- Family doctor and other health care providers.
Important wellness issues or health conditions that impact presenteeism are:
- Mental Health
- Musculoskeletal pain
- Cardiovascular and diabetes
- Cancer
- Seasonal flu
- Chronic psychosomatic pain (stress-related headaches, ulcers, etc.)
Next, list performance objectives (i.e. what should be done) and the ideal expected outcomes for each stakeholder that will impact presenteeism. Or in other words, what should each stakeholder do in order to reach the workplace wellbeing program’s objectives? It is important to do this for each health condition, and each individual stakeholder.
For instance, for employees in terms of mental health we could list:
- The employee participates in the de-stigmatizing of mental health disorders
- The employee learns to openly communicate issues around mental health
- The employee seeks out positive relationships with peers and leadership persons
- The employee knows where to seek out available resources about mental health
- …
Next, match the performance objectives with relevant barriers and facilitators. Focus on changeable “determinants,” both individual and external (environmental). These determinants are what will either help or hinder us in achieving our performance objectives.
Individual determinants depend on the stakeholder, like the stakeholder’s:
- Knowledge, capabilities or skills
- Attitudes, beliefs, and emotions
- Expectations
- Self-efficacy (i.e. trust that one will succeed in achieving the objective)
External determinants depend on the stakeholder’s environment, and include:
- Norms and policies of the organization
- Social support
- Reinforcement (i.e. a consequence that strengthen this behavior in the future)
- Resources of the organization
- Organizational climate
Let us look at one performance objective through the lens of its individual and external determinants.
Employees| Mental Health | De-stigmatizing of mental health disorders
Individual determinants:
Knowledge, capabilities or skills:
- Inform all employees about prevalence of common mental health issues
- Communicate that leadership encourages them to talk about depression/anxiety/mental health issues.
Attitudes, beliefs, and emotions:
- Explain/de-mystify the stigma around mental health
Expectations:
- Demonstrate that talking about mental health problems will get empathy or understanding from organization/peers/etc.
Self-efficacy:
- Build confidence in the ability to discuss mental health problems
External determinants:
Norms and policies:
- Explain anti-harassment and accommodation policies and standards
Social support:
- De-stigmatization training for managers
- Add de-stigmatization training for employees
- Designate “colleague confidants” in each department trained to provide support for employees who want to talk or need resources
Reinforcement:
- Praise individuals who discuss their mental health issues
Resources:
- De-stigmatization training for managers
- Add de-stigmatization training for employees
Organizational climate:
- Demonstrate that it’s okay for the employee to openly discuss issues around mental health as it impacts their function at work
- Demonstrate that the organization cares and will be compassionate towards the issues and managers will be understanding
It can be helpful to combine all performance objectives of a given stakeholder into one matrix, where the performance objectives serve as the rows, and the determinants as the columns. The body of this matrix will then contain who and what needs to be changed and/or learned to achieve the previously set objectives. You can find a complete worked out example of these matrices that is taken from the presenteeism study, here.
Step 3. Develop your strategies (i.e the steps you have to take to reach your goal)–with creativity
Now that you have created an exhaustive overview of desired outcomes, it is time to transform them into workable ideas. While it is important to come up with practical and achievable strategies, first try to come up with creative out-of-the-box solutions. A good way to do this is by using de Bono’s six thinking hats approach.
As the name suggests, this approach forces you to take on six viewpoints:
- The White Hat: Focus only on the facts and the data
- The Blue Hat: Focus only on moderating the discussion
- The Green Hat: Focus only on looking for alternatives, new solutions, and creative ideas
- The Black Hat: Focus only on providing criticism and playing devil’s advocate
- The Red Hat: Focus only on feelings attached to the solutions, both positive and negative
- The Yellow Hat: Focus only on chances, value, and benefits
Bring your wellbeing team together and assign everyone a roll/hat. Together brainstorm and discuss potential solutions. After a given time (e.g. 10 mins), switch up who wears what hat, so that everyone will have had each hat at least once.
Another approach to do is for everybody to come up with both utopian strategies that are not bound to organizational or financial limitations. The goal of these approaches is to stimulate creative thinking, that may result in unique out-of-the-box practical strategies.
Once you have created a list of all strategies, it is time to contextualize them in terms of feasibility, and how well they could be implemented into the current practice. The goal at the end of stage 3 is to have a collection of strategies concerning all health conditions and stakeholders.
Step 4. Finalize and implement the workplace wellbeing program
Now that you’ve developed your strategies and interventions, the final step is to implement the workplace wellbeing program.
Use the “SMART goals” framework (as discussed in more detail in this blog ). That is, ensure each piece of your program is Specific, Measurable, Achievable, Relevant, and Timely. Applying the SMART framework for each stakeholder and each health condition will boost the success of your workplace wellbeing program because it breaks large goals down into manageable, discrete steps.
If your organization already has an ongoing workplace wellbeing programs, it is advisable to perform a gap analysis. As the name suggests, a gap analysis looks at the gaps that exist between what is happening now, and what you want to implement in the future. Start by:
- Making an overview of your desired performance objectives. (as formulated in step 2)
- Making an overview of all the activities you are currently undertaking that are set to achieve the performance objectives
- Comparing the current activities to the activities that are listed in the new workplace wellbeing program
- Note the differences, and evaluate whether these differences can strengthen the new workplace wellbeing program, or whether these differences are barriers that must be dealt with going forward with your new program.
Even if your ongoing workplace wellbeing program is not directly related to the current topic, it can still be a good idea to compare and see where there exist similarities and potential threats and opportunities.
Remember that big changes often take time, so don’t get frustrated if you hit kinks along the way. Continue to learn; obtain employee feedback, identify new problems, consider new solutions, and make revisions if needed. Though this process is framed as being linear, the developers of intervention mapping should note that the process is often iterative. Over time your workplace wellbeing program will continue to improve, further increasing your employee health and productivity.
Recap on a practitioner’s guide to workplace wellbeing programs
Creating a tailor workplace wellbeing program may take some time, but it will be worth the effort. Start with:
- An in-depth needs assessment of your target audience
Use existing administrative data, added with wellbeing surveys, and multiple group discussions/interviews
- Develop program objectives
Write down the desirable outcomes for all stakeholders that are involved both on the organization level, as well as the employees’ private life, and write down all the possible barriers and facilitators that you may encounter in trying to achieve your objectives
- Develop your strategies (i.e the steps you have to take to reach your goal)–with creativity
Blend creative, unique, and out-of-the-box solutions with solid practical strategies to form a feasible methods for reaching your desired outcomes
- Finalize and implement the workplace wellbeing program
Finalize the workplace wellbeing program by fitting all the pieces in a realistic, measurable and achievable timeline. Do a gap analysis to compare the workplace wellbeing program to existing programs for additional insights in possible facilitators and barriers, and implement the program.