HERO Forum18 Conference Proceedings - Health Enhancement Research Organization

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HERO Forum18 Conference Proceedings - Health Enhancement Research Organization
HERO      Forum18
Conference Proceedings
HERO Forum18 Conference Proceedings - Health Enhancement Research Organization

    INTRODUCTION                           19-20                            ENGAGING LEADERS &                PARITY IN HEALTH
                                                                            CHAMPIONS                         PROMOTION
       3-5                                 Health and Benefits Leadership
                                                                            32-34                             42-45
       HEROForum18 Proceedings:            Panel: Achieving Well-Being
                                                                            Intentional Wellness in           Practical Steps Towards Parity
       We’re so glad you made it!          Through Collaboration at all
                                                                            Transportation: Engagement        through Improved Access and
                                           			                              for C-Suite, Drivers and Non-     Treatment in Behavioral Health
    PRE-CONFERENCE                                                          Drivers
    HIGHLIGHTS                             21-22                            			                               DEEP DIVE

       7-8                                 Is Well-Being a Skill that can                                     46-48
       Healthcare Summit Proceedings       be Trained? How Thriving is                                        Workplace Health and
       			                                                                  Engaging Heart and
                                           Accessible from the C-Suite to                                     Well-Being: The Employee
                                                                            Minds Through a Model of
                                           the Shop Floor                                                     Experience
       9-11                                                                 Professional Fulfillment
       Engaging Supervisors to
                                        BREAKOUT                            NEW IDEAS & NEW USES FOR
       Influence Employee Well-Being:                                                                         49-50
                                        SESSIONS                            OLD IDEAS
       Why, What, and How to Get                                                                              Toward Health Equity and
                                           MEASURES FOR THE C-SUITE         37-38
       There                               AND THE SHOP FLOOR                                                 Diverse Engagement: How
                                                                            Weighing in: Addressing
    GENERAL SESSION                        24-28                            Employee Obesity and Nutrition    the University of Michigan’s
    HIGHLIGHTS                             Engaging the C-Suite by          in the 21st Century Workplace     Workplace Well-Being
                                           Connecting Well-Being to         			                               Initiative is Addressing Social
                                           Business Metrics                                                   Determinants of Health
       Research Panel Proceedings
                                                                            Drive Outcomes with a Best
       15-18                               29-31
                                                                            Practice Approach to Strategy,
       From the C-Suite to the Shop        How Hopkins is Getting
                                                                            Culture, and Program Evaluation
       Floor: Making the Workplace         Healthy: Motivating &
       Work Well for Everyone              Measuring Change

HERO Forum18 Conference Proceedings - Health Enhancement Research Organization
    Paul Terry, PhD, President and CEO, HERO

    We are proud to offer our                wondered whether public speakers          And speaking of story-telling, for       movies, and story-telling generally,
    Proceedings from HEROForum18             who seldom publish are in effect          those who attended the first day         Elwood and Jake and their soul
    as a way to reinforce the countless      doing more talking than thinking.         opening of HERO Forum18, you             sister Aretha were on a journey that
    learnings that occurred, to honor        The discipline associated with            were transported back to 1980            unfolded with fits and starts and
    the efforts of our speakers and          organizing post conference                where we rejoined the Blues              surprises along the way. And so
    to give back to our profession,          Proceedings is HERO’s way of              Brothers movie during the rendition      it is with the work of worksite and
    especially for those HERO members        assuring that we capture the best         of Steve Winwood’s “Gimme Some           community health promotion. As I
    and our many other friends in the        thinking from around the nation.          Lovin’.” One of the refrains is “we’re   said in my opening remarks to kick
    health promotion field who were          Please share these Proceedings            so glad you made it,” and the            off the Forum, our learning events
    unable to attend. It has been said       with others as a strategic priority for   song was superbly belted out by          are designed to do nothing less
    that writing is thinking on paper        HERO is to enable more people to          my friends and HERO members              than change the direction of our
    and it’s been observed that many         hear the stories that are unfolding       Stefan Gingerich from StayWell and       field. A dramatic proclamation? For
    writers are essentially talking as       around the nation relating to             Marleece Barber from Lockheed            sure! Our journey, as a profession,
    they write. If that’s true, publishing   advancements and continuous               Martin. Besides that joyous chorus       should hold drama because
    these Proceedings is HERO’s              improvement in employee, family           proclaiming how glad we were you         continuous change will always
    way of letting you “hear” from our       and community health and well-            made it to this learning, networking     evoke questions and predictions
    speakers and it’s our pleasure to        being.                                    and celebratory event, the Blues         about what will happen next as we
    provide you with this gift of their                                                Brothers, you may recall, were on        explore new frontiers together.
    thoughts. Indeed, I have sometimes                                                 a “mission from God.” Like most

HERO Forum18 Conference Proceedings - Health Enhancement Research Organization
After I took off my Elwood Blues hat,   inspiring examples from LabCorp,       question: “When workplace health       and I’d urge you to visit our HERO
    I shifted to a more recent tale and     Lockheed Martin and DHL that           promotion programs work, and           Awards page to learn more about
    likened our journey as professionals    demonstrated how engaging              when they don’t, what makes the        their amazing accomplishments
    to the 270 mile through-hike of the     shop floor employees most often        difference?” As you will read in our   and careers. You’ll see all of our
    Superior Hiking Trail I did in May      starts with leaders making time to     Proceedings, we learned that a         2018 honorees are women leaders.
    of this year. Arduous but gratifying,   gain an intimate understanding         small dose, short-term intervention    I’m a steadfast supporter of the
    hiking is a ready analogy for our       of the daily work of their lowest      spread across thousands of             “Time’s Up” movement and believe
    important work in advancing best        paid colleagues. Similarly, other      employees significantly improved       such harassment issues extend far
    practices in support of health          keynote speakers featured stories      morale but didn’t improve health       beyond Hollywood. As you’ll see
    and well-being. I asked how we          and studies of worksite wellness       at the population level. You’ll also   at a glance in reviewing our HERO
    determine how long we should stay       initiatives that emphasized how        read about other organizations that    awardees in recent years, we also
    on the path we have been most           inclusiveness and sensitivity to a     have long abandoned an approach        believe the time is now to celebrate
    recently exploring. What’s more,        diversity of employee needs and        that focuses on mass screenings        the amazing women who have for
    how and when do we decide it is         values are a vital antecedent to       followed by elective educational       so long led our profession.
    time to forge new trails? There are     improving health at the population     classes. Instead, they are studying
    countless ways to rise to our next      level. As you will also read in the    social determinants of health          Shelly Wolff received HERO’s
    challenges, but two that we focus       many breakout sessions featured        and are exploring new routes to        Bill Whitmer Leadership Award,
    on at Forum are to expose you to        in these Proceedings, practitioners    health for all. We continue to learn   our highest leadership honor.
    pioneers and visionaries alike.         are testing what is working best       that tailoring interventions based     Shelly is a Health and Workforce
                                            in both workplace and community        on interests, building a serious       Effectiveness Leader from Willis
    Pioneers and Visionaries at             settings relative to engaging          investment in culture and making       Towers Watson who has dedicated
    Forum18                                 different population segments. As      the hard choices about policies        her career to health promotion
    Pioneers are those who have             importantly, they shared stories       are a prerequisite to the effective    and has contributed in an
    done the hard work of discovery,        about what approaches are proving      advancement of health and well-        extraordinary range of ways from
    including hitting some dead ends,       to be a detour, or even a dead end,    being for all.                         disseminating research relating to
    so that we can follow the surest        in advancing a culture of health.                                             employee engagement to leading
    path. In keeping with our Forum18                                              Celebrating our Best                   organizations in strategies for
    theme, “From the C-Suite to the         Visionaries are those who bear         Working for a think tank has           reducing unnecessary healthcare
    Shop Floor: Well-being for All,”        witness to the vagaries and risks      more benefits than I can think         claims costs.
    these Proceedings feature articles      of the path we’re on and challenge     through! One advantage that’s
    from presenters who shared              us to consider an altogether           always on the top of my list when      For the first time, HERO honored
    compelling results from efforts         different route, albeit one full of    I’m reviewing how grateful I feel      a research partnership with our
    to build inclusiveness and equity       uncertainty and untold risks. As has   is the many opportunities HERO         Mark Dundon Research Award. Drs.
    into their company initiatives and      been our tradition at Forum, we        takes to honor leaders in our          Kerry Evers and Sara Johnson are
    research methods. For example,          again hosted a research update         profession. We celebrated six          the co-CEOs and co-Presidents of
    our employer panelists offered          panel and this year we asked the       national leaders at HERO Forum         Pro-Change Behavior Systems, Inc.

HERO Forum18 Conference Proceedings - Health Enhancement Research Organization
so it is altogether fitting that they   Gimme Some Lovin in Portland,
    would be the co-winners of our          Oregon in 2019
    Dundon Award. We were delighted         As much as we couldn’t be prouder
    to honor them for their stunningly      of this year’s HERO volunteers
                                                                                  HERO Education Committee
    productive research partnership         and Forum faculty, the HERO team      David Ballard, PsyD, MBA, Assistant Executive Director for Organizational Excellence,
    as federal grant recipients and         are through-hikers and we never       American Psychological Association
                                                                                  Catherine Bass, PhD, Director of Informatics, Onlife Health
    research collaborators. We were         rest in this journey. At the end
                                                                                  Chris Calitz, MPP, Director, Center for Workplace Health Research and Evaluation, American
    also eager to recognize them            of these Proceedings, look for        Heart Association
                                                                                  Stephen Cherniak, MBA, Health Management Consultant, Employee Health and Benefits,
    because their range of research         information about HERO Forum19.       Marsh & McLennan Agency
    interests is also extraordinary as      Our theme for 2019 is: “Thriving      Laura Ellison, MBA, CBP, Senior Manager, Benefits, ADT
    they have studied novel ideas such      Organizations: Achieving Well-        Rick Fisher, Vice President, Aon Hewitt
                                                                                  Lori Huss, PhD, MEd, Director of Humana Wellness Solutions, Humana
    as coaction in behavior change          being through Collaboration.”         Rebecca Kelly, PhD, RDN, FAND, President & Founder, Element Health, Inc.
    alongside proven concepts such          We will be in Portland, Oregon on     Wolf Kirsten, Co-Director, Global Centre for Healthy Workplaces
                                                                                  Karen Moseley, Vice President, Education, HERO
    as the transtheoretical model. They     September 10-12, 2019. Rumor
                                                                                  Patti Rittling, PhD, CHES, Health Management Practice Leader, Marsh & McLennan Agency
    have conscientiously applied these      has it the Blues Brothers and their   Bruce Sherman, MD, FCCP, FACOEM, Medical Director, Population Health Management,
    concepts and have reported on           soulful sister may be back for an     Conduent HR Services
                                                                                  Paul Terry, PhD, President & CEO, HERO
    numerous successful interventions       encore. Talk about “gimme some        Susan Bailey, MS, CIC, SHRM-SCP, SPHR, Director, Total Health & Wellbeing, Marsh &
    ranging from lifestyle issues like      lovin’,” the HERO team loves to       McLennan Agency

    exercise, nutrition and obesity to      oblige and we hope to see you         Healthcare Summit
    addiction issues including opioid,      there. And, yes, besides our usual    Tim Butler, MS, MCHES, Co-chair, Sr. Wellness Program Management Consultant, SelectHealth/
    tobacco use and many other              healthy activities and fare, we’ll    Intermountain Healthcare
                                                                                  Stephen Doyle, MS, MBA, Co-chair, Sr. Director, Strategic Health Management Solutions, UPMC
    intractable public health problems.     serve Voodoo Donuts too!              Health Plan
                                                                                  Cassie Bruce, CWWS Wellness Consultant, Baptist Health
                                                                                  Laura Grubbs, CCWS, Assistant Director, Florida Hospital
                                                                                  Karen Moseley, Vice President, Education, HERO
                                                                                  Dave Schweppe, MPH, CPHIMS, National Vice President, Customer Analytics & Reporting, Kaiser
                                                                                  Ryan Sledge, MPH, MBA, Director, Onsite Clinics and Wellness, OhioHealth
                                                                                  Paul Terry, PhD, President & CEO, HERO
                                                                                  Kaisa Wieneke, MPH, Assistant Director of Employee Well-Being, Mayo Clinic
                                                                                  Jen Wright, MPH, Director, Working Well, SC Hospital Association

                                                                                  University Summit
                                                                                  Patricia Benson, MEd, Co-chair, Director, Get Healthy Now, University of Louisville
                                                                                  Karen Schmidt, MPH, Co-chair, Director, MHealthy, University of Michigan Health & Well-Being
                                                                                  Megan Hammes, MS, MCHES, Director, UI Wellness, University of Iowa
                                                                                  Tamara Iacono, MEd, Senior Program Coordinator, Get Healthy Now, University of Louisville
                                                                                  Mary Imboden, PhD, Membership Manager & Research Associate, HERO
                                                                                  Patty Purpur de Vries, MS, Associate Director, Faculty & Staff Wellness, Stanford University
                                                                                  Anna Threadcraft, RDN, LD, UAB Employee Wellness Director, University of Alabama College of
                                                                                  Human Environmental Services
HERO Forum18 Conference Proceedings - Health Enhancement Research Organization

HERO Forum18 Conference Proceedings - Health Enhancement Research Organization
    Ryan Sledge, MBA, MPH, Director, Onsite Clinics and Wellness, OhioHealth Employer Services

    It’s no secret that rising healthcare   Rachel S. Brown, MD, Medical            programming, and holistic support.      the strategy. Robert J. Krzys, JD,
    costs have impacted providers,          Director of Health and Wellness         Dr. Brown’s experience highlighted      detailed his long lever approach
    payers, employers, and especially       at Palmetto Health, began the           that in this era of consumerism,        (policy/environment level) of Value
    consumers of care. As the burden        discussion exploring the ways the       consumers must be engaged in            Based Intelligent Benefit Design
    has become heavier, patients have       consumer’s mindset has changed          multifaceted ways to drive program      (VBID). This strategy helped
    important decisions to make about       related to health and fitness. Dr.      success.                                coordinate care for the State of
    how they spend their healthcare         Brown especially noted how this                                                 Connecticut’s health plan members
    dollar. Given this climate, it stands   mindset impacts the consumer at         The theme of consumerism                and drive them to services providing
    to reason that consumerism was on       work, and how employers must            continued with a discussion entitled,   the most value. Karen Possidente-
    the minds of healthcare professionals   adapt accordingly. She aptly noted      “Personalized Communications            Leibiger, MBA continued, informing
    gathering prior to HERO Forum           that to engage these health and         and Real-Time Interventions Using       the group on how using a technology
    18. In October 2018, the pre-Forum      fitness-minded individuals, healthy     Consumer Health Informatics,”           platform pulled the short lever
                                                                                    sharing successful strategies           (individual level) in executing the
    Healthcare Summit convened around       habits must be easy to follow in
                                                                                    in engaging consumers. Ellen            State’s VBID plan. This platform
    the topic, “What do Consumers Really    the workplace. As an illustration,
                                                                                    Beckford, PhD, MPH, explained the       allowed Karen’s organization, Care
    Want? Health System Transformation      Dr. Brown shared her Wellness @
                                                                                    “lever” concept in driving behavior     Management Solutions, to target
    in the Era of Consumerism.” The         Work program at Palmetto Health,
                                                                                    change. According to Dr. Beckford,      member and PCP communications to
    half day summit explored the            a department-level intervention
                                                                                    the length of the lever needed to       drive utilization of appropriate health
    transformation of healthcare and how    featuring application to participate,
                                                                                    drive change is directly related        services.
    consumerism shapes the future.          initial assessment, tailored
                                                                                    to how far an individual is from
HERO Forum18 Conference Proceedings - Health Enhancement Research Organization
The summit’s final presentation            solutions, real-time communications
    focused on how the middle                  and technology, and storytelling can
    managers of an organization can            drive consumer buy-in and ultimately
    impact a healthy culture. As Kaisa         behavior. The healthcare industry is
    Wieneke, MPH discussed, healthcare         transforming, and consumers are in
    workers traditionally focus on             the driver’s seat.
    the needs of others, even at the
    detriment of their own well-being. As      This year’s speakers included the
    such, storytelling can be an effective     following experts:
    way to demonstrate the necessity for       • Tim Butler, MS, Wellness Program
    investing in health promotion. This           Management Consultant,
    concept that Cristin Cooney calls             SelectHealth/Intermountain
    “the why” is effective in encouraging
                                               • Stephen Doyle, MS, MBA,
    management and employees alike.
                                                  Sr. Director, Strategic Health
    Elena Valentine, CEO & Co-Founder
                                                  Management Solutions, UPMC
    of Skill Scout, noted that these stories      Health Plan
    can be shared in various ways. She         • Rachel S. Brown, MD Medical
    and her company have success                  Director of Health and Wellness &
    using video as a medium to bring              Family Physician, Palmetto Health
    the stories to life. The climate of        • Ellen Beckjord, PhD, MPH
    consumerism reminds us that hearing          Associate Vice President of
    the voice of the customer is an              Population Health and Clinical
    important concept that organizations         Affairs, UPMC Health Plan
    must embrace.                              • Robert J. Krzys, JD Principal,
                                                  Strategic Health Solutions
    The 2018 HERO Healthcare Summit            • Karen Possidente-Leibiger, MBA
                                                  Vice President, Care Management
    closed with table discussion
    synthesizing the learnings of
                                               • Kaisa Wieneke, MPH Assistant
    the day. Healthcare consumers
                                                  Director of Employee Well-Being,
    may be patients, employees, or                Mayo Clinic
    even organizations. In this era of         • Elena Valentine CEO & Co-
    increased consumerism, these                  founder, Skill Scout
    utilizers of services have choices         • Cristin Cooney, MEd, MS, MCHES
    in how they spend their healthcare            Director, Occupational Health
    dollar. The thoughtful dialogue in this       Services & Team Member
    summit demonstrated how targeted              Wellness, Atlantic Health System

HERO Forum18 Conference Proceedings - Health Enhancement Research Organization
    Kaisa Wieneke, MPH, Assistant Director for Employee Well-Being, Mayo Clinic; Assistant Professor of Healthcare Administration and Family
    Medicine, Mayo Clinic College of Medicine

    The perception of employee            is more likely to have lower stress   survey results have demonstrated          their perceptions can potentially
    wellness programs as a necessary      and higher job satisfaction than      that having a well-being champion         enhance the employee experience
    expense to reduce future health       an employee without a supportive      in a work unit, coupled with an           and optimize the impact these
    care spending has shifted to that     supervisor.5 The quality of the       organizational commitment to              leaders can have in advancing
    of a crucial investment for shaping   relationship has been linked to       employee well-being, is associated        employee well-being initiatives.
    organizational culture, building      both employee outcomes and unit       with better employee engagement,
    brand equity, and facilitating the    performance.6                         job satisfaction, and a greater           Methods
    recruitment and retention of top                                            perception of personal well-being.        To understand the supervisors’
    talent.1 To accomplish such goals,    Mayo Clinic has recently taken a      To build on these findings, Mayo          perspectives, Mayo Clinic employee
    organizations are focusing on         bolder, more holistic approach to     embarked on a novel approach              well-being staff conducted
    the shared responsibility of both     their worksite wellness program       to examine supervisors and how            semi-structured interviews with
    the individual employee and the       and initiated a more organic          their roles impact employee well-         supervisors across the organization.
    organization itself.2 This includes   approach by exploring the various     being within a work unit. Particularly,   This qualitative method for research
    the role of supervisors and mid-      roles within an organization. A       this new research was designed            was selected to gain depth and
    level managers as key influencers     robust well-being champions           to develop a more precise                 richness around key concepts. A
    within the work unit for employee     program was developed and             understanding of the current              semi-structured interview guide
    engagement.3,4 An employee with       studied based on the theory of        barriers, needs, and perceived            was designed to elicit information
    a supervisor viewed as supportive     social networks.7 Recent all-staff    roles of supervisors. Understanding       about how supervisors viewed
HERO Forum18 Conference Proceedings - Health Enhancement Research Organization
their role regarding employee             Statements such as “I don’t think          their personal well-being through       team has developed an online
     well-being, to identify barriers to       that I can do that if it’s not affecting   their own behaviors and their           “Supervisor Toolkit” to retain ready-
     participating in wellness initiatives     their performance” indicated some          level of engagement,8 we must           made electronic communications,
     and to determine resources that           hesitancy to having a formal role.         also consider the workplace             resources, and recommendations
     could better support supervisors in                                                  environment and level of                for supervisors to integrate well-
     encouraging staff engagement in           Barriers from the supervisor               organizational support as programs      being into the work unit. Bringing
     wellness initiatives.                     perspective included: high current         are engineered to enhance               these resources to one location
                                               workload, ambivalence about                employee well-being.                    allows for easier access since it is
     We conducted twenty interviews            promoting wellness, lack of support                                                clear that supervisors are limited on
     which were audio recorded,                from leadership, lack of flexibility       By gathering supervisor feedback        time. Supervisors felt disconnected
     transcribed, and analyzed in              and control at work, and difficulty        in a methodical manner, we              with top leadership; therefore,
     iterative phases by employee well-        accessing onsite resources.                have a deeper understanding             the toolkit also emphasizes key
     being staff and trained qualitative       Qualitative feedback expanded              of the personal experiences of          messages from top leaders to
     research analysts. The analysis           on each of these areas to include          this employee population which          provide further reinforcement. In
     included content log development          statements such as employees               may have been overlooked in a           addition, recommendations focus
     and open coding by a trained              being “very, very dedicated to             quantitative method of research.        on issues which supervisors can
     analyst to reveal key themes. More        the patients. And they don’t take          The supervisors’ personal               control within their work unit since
     formalized content coding using           breaks.” Or, referencing supervisors’      experiences and stories provided        lack of control was a stated barrier.
     specialized software for qualitative      perspectives of leadership, noting         rich data for the employee well-
     analyses was also conducted.              that “sometimes leadership doesn’t         being team to develop meaningful        Understanding supervisors have
                                               stop to look at managers and               action plans to address supervisor      limited time, additional opportunities
     Results                                   say, ‘Are we trying to implement           and employee needs.                     for skill building should be
     Supervisor responses were wide-           too many things all at one time?”                                                  and have been integrated into
     ranging regarding their perceived         That the work culture may not              The action plan was developed           existing leadership courses at our
                                                                                                                                  organization rather than creating
     and desired role in promoting             support well-being efforts is              based on interview results and
                                                                                                                                  new courses. Organizational
     workplace well-being. They                indicated by statements such as            focuses on four main themes:
                                                                                                                                  policies and safety protocols are
     perceived their potential role            “I’m not sure how much it would            awareness and education,
                                                                                                                                  included in institutional resources
     as “being that role model” and            be supported by their work peers.”         leadership competencies, skill          such as the “new hire checklist” and
     encouraging staff to participate in       Lack of knowledge about existing           building, and prioritizing leadership   “new manager checklist.” These
     wellness activities. Twelve of the        resources was often identified             support. (See Table for details.)       resources have also been updated
     twenty supervisors felt it should be      as a need, demonstrating the               These four areas were developed         to include a focus on employee
     a part of their overall performance       opportunity to increase awareness          based on interview results. For         well-being, thus establishing
     assessment. However, others               of current offerings.                      example, awareness and education        employee well-being as a
     had not considered it prior to the                                                   is a primary focus due to the lack of   professional responsibility during
     interview or did not feel it was a        Implications                               knowledge determined by needs           the onboarding process of new
     part of their role for various reasons.   While an individual can impact             mirroring existing resources. The       employees and managers.

In lieu of the incorporation of well-   References
                                                                                                    Action Plan to Enhance Involvement of Supervisors for Employee Well-Being.
                                             1. Terry PE. Autonomy and companionate love:
     being into a performance review,            do we need a revolution in employee wellness                               • Online supervisor toolkit with ready-
                                                 offerings? LinkedIn; 2018 March 14. https://www.
     we recognize other barriers need            linkedin.com/pulse/autonomy-companionate-                                     made communications, resources, and
                                                                                                    Awareness and Education
     to be addressed first in order to           love-do-we-need-revolution-employee-paul-                                     recommendations to integrate wellness at the
                                                 terry/                                                                        work unit level
     equip supervisors and establish         2. Shanafelt TD, Noseworthy JH. Executive
     the culture. Meanwhile, an all-staff         leadership and physician well-being:                                      • Emphasis of well-being within institutional “new
                                                  nine organizational strategies to promote         Leadership Competencies
     survey that Mayo Clinic regularly                                                                                         hire checklist” and “new manager checklist”
                                                  engagement and reduce burnout. Mayo Clin
     administers has a greater emphasis           Proc. 2017;92(1):129-146.                                                 • Integration of well-being into Leadership and
                                             3. Linnan L, Weiner B, Graham A, Emmons K.                                       Organizational Development courses
     on employee well-being with                  Manager beliefs regarding worksite health         Skill Building
                                                  promotion: findings from the Working Healthy                              • Online supervisor toolkit resources to integrate
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     priorities for the organization and          528.
                                                                                                                            • Online supervisor toolkit highlights leadership
                                             4. McCalister KT, Dolbier CL, Webster JA,
     expectations for supervisors to              Mallon MW, Steinhardt MA. Hardiness and                                      quotes and videos
     address areas of concern.                    support at work as predictors of work stress                              • Keynote presentations to well-being champions
                                                  and job satisfaction. Am J Health Promot.
                                                                                                    Prioritizing Leadership    and supervisors
     Future efforts aim to replicate         5. Nielsen K, Randall R, Yarker J, Brenner S-O.       Support                 • Online videos of top leadership promoting well-
                                                  The effects of transformational leadership on                                being
     previous interventions2 which will           followers’ perceived work characteristics and
                                                                                                                            • Engage leaders as executive sponsors for well-
     further engage the supervisor. This          psychological well-being: a longitudinal study.
                                                                                                                               being activities
                                                  Work Stress. 2008;22(1):16-32.
     will include conducting additional      6. Gerstner CR, Day DV. Meta-Analytic review of
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                                             7. Wieneke KC, Clark MM, Sifuentes LE, et
     a work unit in order to create a            al. Development and impact of a worksite
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                                                 Behav. 2016;40(2):215-220.
     burnout.                                8. Berkland BE, Werneburg BL, Jenkins SM, et
                                                  al. A worksite wellness intervention: improving
                                                  happiness, life satisfaction, and gratitude in
     The findings from this study                 health care workers. Mayo Clinic Proc Inn Qual
     are intended to gently provoke               Out. 2017;1(3):203-210.
                                             9. Wieneke KC, Schaepe KS, Egginton JS, et al.
     practitioners to consider the                The supervisor’s perceived role in employee
     perspectives of the target audience          well-being: results from Mayo Clinic. Am J
                                                  Health Promot. 2018:890117118784860.
     when developing initiatives and
     allowing for their perceptions to be
     combined with those of Mayo Clinic
     experts and positioned alongside
     known best practices for advancing
     employee well-being.

     Full results and interview quotes are
     published in the American Journal
     of Health Promotion.9


     Colleen Saringer, PhD, MEd, FVP Lead Wellness Consultant, Alliant Employee Benefits

     Health and well-being initiatives       of Finance and Economics,                the Illinois Workplace Wellness            employees in a treatment group
     work; we know that. We also know        University of Illinois; Kristi Rahrig-   Study that led to headlines in the         who were eligible were invited to
     that it wouldn’t be a day in the        Jenkins, PhD, MPH, Research              news claiming, “once and for all,          participate in a wellness program
     world of “wellness” if we weren’t       Program Manager, University of           wellness programs don’t work.” Dr.         and employees in the control group
     combatting the naysayers who            Michigan; and Megan Amaya,               Goetzel reminded us that we know           were not. From a non-significant
     ever so eloquently stretch valuable     PhD, CHES, Assistant Professor of        this is false, and pointed out there       findings perspective, they learned
     research into a “newsy negative”        Clinical Practice, Director of Health    is value in this study right from the      that average medical spend in
     to generate online clicks. It’s the     Promotion and Wellness, The Ohio         start given it’s the first randomized      the control group was not greater
     reason why, year over year, HERO        State University. Before looking to      control trial (RCT) in a workplace (i.e.   than the treatment group, and that
     looks to Ron Goetzel, PhD, VP of        the panel to discuss what makes          the University) to ask the question:       there were no differences in days
     Consulting & Applied Research,          the difference when implementing         “Do these programs work?” To date,         off (productivity) between the two
     IBM Watson Health to help us see        health and well-being initiatives in     studies are often observational in         groups. From a significant findings
     through the literature to determine     the workplace, Dr. Goetzel kicked        nature which means control groups          perspective, it was uncovered
     what works and what doesn’t.            off the session by sharing a short       are not integrated, and participant        that the employee morale in the
                                             story of the individuals who devised     data is compared to non-program            treatment group was greater than
     In this year’s much anticipated         the field of behavioral economics.       participants.                              that of the control group. This is an
     General Research Session, Dr.           Reason being, it allowed for the                                                    important finding given the constant
     Goetzel led a panel that included       segue into hearing from Julian Reif,     Dr. Reif began with a high-level           challenges the industry faces when
     Julian Reif, PhD, Assistant Professor   one of the lead researches behind        overview of the study. In short,           charged with explaining the value

of a health and well-being initiative   dimensions (e.g., financial wellness)     “What can we do for you?” Over
     within the workplace. In addition to    at the University through a RCT. At       time, many of these individuals will
     sharing the results, time was taken     this point, Dr. Goetzel pivoted with      begin to participate. Although not
     to discuss the study’s limitations.     a comment to Dr. Reif that leading        the exact prescription as defined by
     Specifically, the results only took     an RCT in the business world is           Dr. Rahrig-Jenkins, Dr. Amaya noted
     into account the first year of the      an extreme challenge; companies           that their approach is similar. Dr.
     study. Also, Dr. Reif acknowledged      will not participate. Dr. Reif agreed,    Goetzel extended this question in
     that what was being studied from        noting that because of this, you          a slightly altered manner to Dr. Reif,
     a program perspective in his            often have to turn to the best            specific to achieving an outcome
     university setting should not be        evidence available, keeping in mind       of interest. His response echoed
     generalized to other organizations.     that it may not provide the same          what was previously summarized:
     These limitations are important for     level of certainty.                       “Meet the employees where
     two reasons: 1) we know significant                                               they are at/what their individual
     effects in year one of any health       Dr. Goetzel then directed a question      needs reflect (e.g., paid time off
     and well-being initiative are           to Drs. Rahrig-Jenkins and Amaya          for participation, or host the event
     unlikely; and 2) if companies are       about engaging those who are              where the greatest congregation
     intent on following evidence-based      less likely to participate in program     of employees exists in order to
     initiatives, coupled with the goal      offerings and/or are low wage             remove attendance barriers).”
     to meet the unique needs of their       workers. Specifically, he asked
     population, we must look deeper         “How do you get them involved?”           As the panel closed, Drs. Amaya
     into generalization given one size      At the University of Michigan, they       and Rahrig-Jenkins addressed
     does not fit all.                       take the approach of relationship         where additional needs exist
                                             building. In short, they target           in research (e.g., Wellness
     Following this overview, Dr. Reif       focused partnerships with units that      Champions), and expressed
     rejoined Drs. Rahrig-Jenkins and        have a high percentage of lower           appreciation to Dr. Reif for his
     Amaya to provide feedback on the        wage workers and/or high health           contributing literature. Dr. Goetzel
     question: “How do you go about          risks. Leveraging their wellness          signed off with one final suggestion
     designing and delivering health and     champions, they work to build trust       for Dr. Reif: “Next time, why not
     well-being programs and what are        with the employees who make up            reconsider your headline for
     some challenges?” Dr. Amaya, from       the unit(s), which means they don’t       the news. Rather than ‘Wellness
     The Ohio State University, pointed      come in with an agenda on what            Programs Don’t work,’ how about
     toward their nine dimensions of         they’d like to accomplish (e.g.,          ‘Wellness Programs Significantly
     wellness, noting that some are          participation; a specific health risk).   Improve Morale’.”
     harder to tackle than others and        Instead, they meet the employees/
     that the challenge lies within the      unit(s) where they are at during
     opportunity to go deeper within the     that point in time, by simply asking,

     Elena Valentine, CEO, Skill Scout • Diana Han, MD, Chief Medical Officer, GE Appliances • Shane Jackson, President, Jackson Healthcare
     Reported by Barbara Tabor

     Elena Valentine                       employees realize incredible health     People want to bring their whole       realistic. This is where ethnography
     “I’m Elena and I’m a workplace        results because of the culture          selves to their jobs because they      comes into play. Ethnography
     geek.” What I love about exploring    their leaders have created, which       work so many hours and give so         is a research method to help us
     careers and the world of work is      ultimately makes them very loyal        much to their jobs. The separation     understand how people live their
     the people who make up these          to the company. Many of these           of work and life is disappearing, so   lives. This, in essence, is what
     companies and the stories they        employers truly “get wellness.”         we tend to bring our personal life     “Undercover Boss” does. This is
     have to tell. Somehow, I have         They realize it’s not a nice to have,   and well-being to work and vice        what we do at Skill Scout and it’s
     finagled a career of researching      it’s a must have, especially when it    versa.                                 what workplace wellness needs.
     and celebrating other people’s        comes to attracting and retaining
     works and have been in every          employees and meeting the               While research and data are very       There are three types of
     type of workplace as we work with     needs of workers who are nearing        important, it only gets us so far      ethnographic mindsets:
     companies around the world to         retirement and millennial workers.      because wellness is personal and       1. Get out of the armchair. If you
     create videos that tell their brand   And the reason they have this           personally charged. When we                want to understand how a lion
     and culture stories to potential      understanding of their workforce        look at data, we ask the question:
                                                                                                                              hunts, you don’t go to the zoo,
     employees.                            and of workplace wellness is            “How can we bring this to life for
                                                                                                                              you go to the jungle. How can
                                           because they spend a whole              employees?”
                                                                                                                              you immerse yourself in your
     We have grown our business by         lot of time on the shop floor and
     working with small and mid-sized      they know all of the jobs because       For large employers, spending              workplace environment?
     industrial companies. We have seen    they’ve done all the jobs.              time on the shop floor isn’t always
Dr. Diana Han Dr. Han leads the health services team at GE Appliances and is
     responsible for the onsite delivery of occupational and preventive health services
     and programs, health benefits, lead management and health improvement. She is               Elena Valentine, CEO, Skill Scout Elena is a designer by training but
     trained in internal medicine at Mass General.                                               has a research background. She is founder and CEO of Skill Scout and is an expert
                                                                                                 storyteller. Skill Scout’s job is to bring jobs to people and to help employers attract
     GE is a Haier Company that is based in Appliance Park, Louisville, KY with 12,000           the right workforce.
     US employees and 80,000 global Haier employees at multiple factories around the
                                                                                                 “You cannot be what you cannot see. I represent a generation that ranks industrial
                                                                                                 jobs as dead last in career choices. We go to schools where shop classes and jobs
     “  Being on the front line and in the trenches with our employees who could be front-
     line workers or executives in a manufacturing setting is about either eating my own         in these areas are seen as less than. What attracted me to manufacturing is that their
     dog food or drinking my own champagne, depending on the day. We have a very di-             leaders have been our biggest advocates and they have wonderful stories and such
     verse population within our workforce — some who have hourly jobs without flexibil-         passion for their industries. I continue to admire that and I look to them as some of
     ity and others who have all the flexibility in the world. We can focus on a single lever    the best leaders I’ve ever known. ”
     to try to shift costs, but if we aren’t focusing on improving care, it’s a fool’s errand.

     2. Zip your mouth and watch and                  understand how others are                    how they feel and to bring the             happiness and well-being in every
         listen. Learn how to sit back and             feeling and what their experience            data to life.                              home. We had to think about how
         listen and foster space with your             is. This can take the form of             This approach is already working to           we were going to achieve this
         workers.                                      “show me” and “tell me.” And              improve health outcomes and it all            lofty purpose. Since launching
     3. Embrace the unexpected. You                   look at what can be learned from          starts with you. As an ethnographer,          this purpose, we have become
         may come in with one hypothesis               analogous experiences (what can           you are ultimately a storyteller              the fastest growing appliance
                                                                                                                                               manufacturer in North America.
         and realize that it’s wrong or                we learn from others who are              and you are fostering a culture of
                                                                                                                                               We’re gaining share in a difficult
         that there are eight potential                outside of our daily experience).         belonging and sharing. It starts with
                                                                                                                                               market, so something has changed
         hypotheses that could be true.            3) Walk in their shoes. What if you          us and we have to ask ourselves
                                                                                                                                               for our employees as we are
                                                      were to experience what it’s               the questions: What are my                    tracking to this different purpose.
     Different methods of ethnographic                like working on the shop floor             definitions of wellness? What are
     research:                                        or visit them at home. When we             my own barriers to wellness?                  One of our guiding principles at GE
     1) See. Simply watch and take notes             started Skill Scout, we applied                                                          is “Happiness and well-being start
        and gather context based on                   for hundreds of jobs, just to              Diana Han
                                                                                                                                               with our GEA Family.”
        how people behave. Sit in the                 experience the frustration and             At GE, we make appliances, but
        lunchroom and watch how people                the journey of people who are in           what are appliances these days?
                                                                                                                                               Having and communicating a
        are selecting their food and what             the job market.                            Today, appliances are connected
                                                                                                 and do much more than perform                 guiding principle is paired with a
        they are doing on their lunch              4) D
                                                       rop the pen and pick up a                                                              deeper commitment to all aspects
                                                                                                 a simple function, thanks to the
        break or before and after the                 camera. Let people share in their                                                        of our employees’ health and
                                                                                                 Internet of Things.
        workday starts.                               own words what their experience                                                          well-being, including the physical,
     2) Experience it and gain empathy.              is like so executives can see                                                            emotional, social and financial
                                                                                                 In 2017, we defined a new purpose
         Be able to feel and inherently               what employees are saying and              for our company: To enable                    health of employees.

Shane Jackson Shane is president of Jackson Healthcare, which is made up
     of 17 companies and 1,400 associates. Jackson Healthcare provides temporary and
     permanent staffing for healthcare workers and services across the country. He was
     named among the 100 most influential people in the staffing industry. Shane spear-
     headed a nonprofit organization called ”Connecting Kids and Care,” and is author of
     the book “Fostering Culture.”

     “One thing we apply to our business model is a “return on investment in giving”
     rather than a traditional ROI. The time we invest in this is a real asset and believe we
     should hold this to the same standards as a traditional business investment because
     there can be tremendous value in giving. The business case for volunteering and
     exposing your people to the gift of service and how these experiences can change
     your perspective and change your view and perspective on your customers.       ”

     We offer primary care and                     One of the reasons I still see               We don’t approach wellness with         Jackson Healthcare offers an onsite
     occupational health onsite, mental            patients is so I can continue to             the hubris that “we’re going to         clinic for employees and families,
     health and therapy, onsite physical           “feel the real.” Being embedded              change you,” but with the goal to       as well as an onsite pharmacy and
     therapy and personal trainers, case/          with your population is incredibly           better understand how to work           mail order Rx, onsite and mobile
     care managers, an onsite clinic,              important because when things                with and support employees and          screening units, virtual care, onsite
     disability insurance, workers comp            break down for an employee, you              understand what they want, where        golf course (mini golf), onsite
     and FMLA. WellWithin is the brand
                                                   are better equipped to support               they come from, and how we can          cafeteria and healthy food with an
     for our well-being program and our
                                                   them because you understand what             meet the rhythms of their daily lives   emphasis on locally grown produce.
     motto is “Making the workplace
                                                   their work and home situation                and the shop floor.                     “Love Lifts” is a community initiative
     work well for everyone.” This
     means:                                        might be.                                                                            that we embrace as a company and
     • Reframing the “why” of work and                                                         Shane Jackson                           we expect all employees to spend
        transcending our purpose.                  At the end of the day, an “office”           The mission of Jackson Healthcare       at least one day in community
     • Meeting employees where they               can be a service delivery person’s           is improving the delivery of patient    service each year.
        are.                                       van, or a salesperson’s car, or a            care for the lives of everyone we
     • And fitting wellness organically           home office, or a traditional office or      touch and that manifests itself in      One of the questions we get is “Is
        into the natural rhythms of the            shop floor. This means that what we          many ways. We are the third largest     it worth it?” And while that can be
        workplace.                                 offer has to be available in different       healthcare staffing companies in the    a difficult question to answer, I can
     Our programming must be                       formats, across different channels,          country with 1,400 associates and       point to some specific outcomes,
     culturally tuned to deepen inclusion          and we have to be super culturally           6,500 clinicians in all 50 states and   including:
     and diversity and to enhance                  tuned so what we do resonates                we see 6 million patients at 2,000      • 82% of employees completed
     connectivity among people, and it
                                                   with who people are and where                healthcare facilities nationwide           their HRA.
     must be owned by all functions.
                                                   they are in their lives.                     each year.                              • 70% are fitness center members.

• 80% use onsite clinic and              and was able to reach great levels      actions we take in the workplace.         and thinking about that for the long-
        pharmacy.                              of success. When you achieve            Our values and beliefs drive the          term, that creates an atmosphere of
     • Our annual healthcare cost             success that way, you can either        decisions we make, which inform           wellness.
        increase is less than ½ the            have a sense of pride in who you        our culture.
        industry average increase.             are and what you accomplished or                                                  Of all the levers you have to impact
     • We’ve seen half the amount of          you can have compassion for all         Jackson Healthcare values:                people’s behavior, you have to start
        employee turnover as the rest of       human beings and understand how         • Others first (put the best interests   with their values and beliefs.
        the industry.                          people at different levels of society      of others before yourself)
     • Our growth rate is double average      feel and how people look at them.       • Wisdom (implies a long-term
        industry growth rate for 10 straight                                              perspective)
        years.                                 As the founder of the company, his      • Growth (keep getting better).
                                               personality as a compassionate
     To understand our business, you           leader is what was imprinted on         We have a lot of people who
     have to understand my father.             the company. We have no class           are really aligned around these
     My father had what most would             system because no one is any more       values and especially within our
     consider to be a horrible childhood,      important than anyone else.             leadership. When people work
     bouncing from one housing project                                                 with Jackson Healthcare, they say
     to another until his uncle placed         Shane’s definition of culture: The      they have the opportunity to work
     him into the foster care system. He       atmosphere that results from the        on something that’s bigger than
     eventually ended up with a family         actions a group takes to accomplish     themselves. When you have people
     that became my grandparents. My           its purpose. Culture is generated       who are really aligned and thinking
     dad literally came from nothing           by the decisions we make and the        about what’s best for other people

     Moderator: Seth Serxner, PhD, MPH, CHO & SVP of Population Health, Optum • Panelists: Marleece Barber, MD, CMO, Lockheed Martin • Betty Jo
     Saenz, MBA, MPH, Director, Benefits, DHL • Kim Beck, Senior Benefits Professional, LabCorp • Reported by: Roshi Fisher, MPH, CPH, CHES,
     Sr. Consultant, Lockton • Heidi Guetzkow, TRS, National Program Manager, Lockton • Sarah Smith, Sr. Consultant, Lockton
     Seth Serxner opened the session      retire and meet personal life goals.   and ancillary benefit offerings in    and have a BMI of 29.9 or less.
     by asking each of the panelists      Lockheed Martin’s well-being           their wellness, life and disability   To reach these goals, LabCorp
     to provide information about         strategy 2.0 incorporates emotional    programs.                             provides a variety of resources
     their organizations and how they     and financial wellness as central                                            and tools including online wellness
     approach health and well-being.      components of the program.             Kim Beck - Laboratory Corporation     programs, health coaching, disease
                                                                                 of America, Holdings (LabCorp)        management, Weight Watchers,
     Marleece Barber - Lockheed           Betty-Jo Saenz - DHL                   LabCorp is a global life services     EAP and fitness reimbursement
     Martin                               DHL is the world’s leading mail        company with nearly 60,000            programs. The organization
     Lockheed Martin has over 100,000     and logistics group which employs      employees worldwide. The              has seen favorable results in
     employees and is the largest         approximately 520,000 employees        organization sees more than 115       employees quitting smoking and
     defense contractor in the world.     in more than 220 countries             million patients each year and        managing their weight.
     Their mission around health and      throughout the world. DHL focuses      supports clinical trials in 100
     wellness is to create a population   on these well-being themes: live       countries throughout the world.       Serxner facilitated the conversation
     of educated healthcare consumers.    more, do more, play more, learn        The foundation of LabCorp’s           with the panelists with a focus
     Communications include how           more, plan more, be more. They         wellness program is built on          on the Forum’s theme, From the
     health impacts the employees’        take a holistic approach to well-      rewarding employees for meeting       C-Suite to the Shop Floor: Well-
     bottom lines and their ability to    being by integrating health care       specific goals: to be tobacco free    being for All.
Manager Buy-In and Engaging              Engaging the safety leader has          help your family life? How does
     Leaders                                  proven to be a successful strategy.     your mission make Lockheed the
     At DHL, both managers and                                                        best company? With the war on
     employees needed to know why             At LabCorp, leading by example is       talent, it is more important than
     they are being asked to participate      paramount. Leadership was very          ever for the organization to score
     in well-being activities. To gain buy-   receptive to show their support         high when employees are asked if
     in companywide, the organization         of the well-being program by            the organization cares about their
     focused on being transparent and         creating videos of them engaging        health and well-being.
     using very direct communication          in health and well-being activities.
     strategies. For example, when DHL        Leadership embraced the need to         LabCorp is shifting focus to well-
     wanted more employees to have            visibly support the program and         being with a strong tie into the
     an annual physical, the messaging        honestly share the message that         company mission. The well-being
     indicated healthcare costs were          wellness creates company savings.       program impacts employees’
     increasing and completing                                                        lives and that message should be
     preventive care can help lower           Diversity in the Workplace              delivered effectively to employees.
     costs. Transparent messaging             Lockheed Martin’s various affinity      Healthy competition is a motivator
     provided clarity to employees            groups are embraced and                 companywide, therefore efforts
     and gave managers what they              supported as part of the fabric         are underway to tie the program
     needed to allow participation. DHL       of the organization. Recently,          into business units’ performance
     utilizes more than 15 methods            the organization invited select         metrics. LabCorp is currently
     of communication to maximize             members of these affinity groups to     considering program inclusion of
     reach across the employee base.          join in the benefit planning process.   spouses to support employees both
     Communications are crafted with          Having employees at the table           inside and outside of work.
     the following questions in mind:         brought different perspectives to be
     What is important to employees and       considered and a new way to view        DHL is considering how benefits
     why? What is the reason employees        issues of diversity and inclusion.      and wellness are unique to each
     would participate in this initiative?                                            employee. They are also working
                                              Embracing Well-Being - What’s           to align the well-being program to
     At Lockheed Martin, managers             Next?                                   corporate objectives; it is clear the
     are motivated by productivity; if        Lockheed Martin wants employees         program has improved employee
     the well-being program can be            to live their best lives and strives    health and productivity, enabling
     tied to getting products out on          to enable them to do so. The            DHL to deliver packages more
     time they will more likely support       approach is mission oriented –          effectively, on time and with fewer
     the initiatives. Managers listen to      employees are asked questions           safety concerns.
     messaging relative to occupational       such as: What is your personal
     health, absenteeism and safety.          mission? How does your mission

     Eric Langshur, Co-founder and Managing Partner, Abundant Venture Partners; Co-founder and CEO, AVIA • Reported by Barbara Tabor

     The human mind is an incredibly        fact, neuroplastic and can reform         • Negativity bias. We are                 70,000 thoughts per day and that
     powerful thing. The way our brain      itself and generate new neural               conditioned to remember the bad         90 percent of those are recurring
     functions influences how we feel       connections throughout our lifetime.         over the good. When it comes            thoughts and 80 percent have a
     emotionally, which influences the      This means the brain has the ability         to avoiding things that can harm        negative tinge to them and it’s not
     way we feel physically and how         to compensate for injury or disease          us, this can serve a purpose.           surprising that many of us are in a
     we perform in all areas of life. And   and to adjust and reshape itself to          However, it also can cause us to        constant state of anxiety. And the
     here’s the kicker: By understanding    respond to new surroundings or               fixate on our failings or things that   Modern Secret is: We’re all in it
     a few basic principles we can          situations. So, you can, in fact, teach      might have been.                        together.
     retrain our brains to respond to       an old dog new tricks.                    • Time travel. Humans are the only
     environmental cues in ways that                                                     species that time travel, in that       This plays out in several ways in
     foster good health and well-being.     This is extremely important because          we’re constantly thinking about         society. Take social media, for
                                            humans share three common                    the future and the past and are         example. No one plays their B side
     The beauty of the basics and the       biological realities:                        constantly running simulations of       on social media, which leads us
     idea of neuroplasticity                •V
                                              igilance and anxiety. Our brains          what went wrong and what could          to constantly compare our lives to
     It’s a commonly held belief that        are conditioned to be on high               go wrong in various situations.         those in our extended social circles.
     we lose brain power and function        alert for danger and to fight or flee                                               And if our B side isn’t as impressive
     as we age. However, science             things or situations that may harm       Add to these shared realities the          as our neighbors’ it can make us
     has shown us that the brain is, in      us.                                      fact that the average person has           feel anxious and depressed.

As a nation, we are impaired: 1 in 7     can do in life is breathe. When we       shown that productivity increases,       And because we understand the
     people suffer from a sleep disorder,     take the time to practice a “four-       we’re more energized and overall,        science of behavior change, we can
     1 in 10 are addicted to alcohol          by-four breath” we engage our            we feel better. If you’ve ever heard     develop cues that will trigger better
     or drugs, 1 in 5 have an anxiety         parasympathetic nervous system,          someone say, “I’m more productive        habits.
     disorder, and 1 in 4 suffer chronic      which releases hormones that relax       when I’m busy,” that’s because they
     pain. When we’re feeling tired or        us. Taking a four-by-four breath is      are experiencing flow. According         The three C’s of habit change
     feeling down, it’s natural to look for   a beautiful way to become present        to a study by Marty Seligman of          1. Cue — Build cues into your
     a distraction or something that will     in a given situation because you’re      500 high school students, kids who           day that support better health
     take our minds off the way we feel.      actually focusing on the moment.         studied hard and were in multiple            behaviors.
     For a majority of people today, that     And, it’s completely portable — you      activities, years later had higher       2. Commence small — Implement
     distraction comes in the form of         can unpack and implement a four-         well-being scores and had gone on            small changes into your daily
     our smartphone or mobile device.         by-four breath anytime, anywhere.        to college and had higher-paying             routine and set incremental goals
     It’s estimated that the average          To make four-by-four breathing           jobs. Studies have also shown that           for yourself.
     person touches their phone 2,617         a part of your daily routine, try        the part of our brain that is critical   3. Commit — Once you decide
     times per day. And what happens          building cues into your daily routine.   or negative and that asks nagging            to make a change in your life,
     then? We look at social media and        For example, when you’re waiting         questions is quieted when we are in          fully commit. If you make a 99
     see everyone else’s highlight reels      in line for coffee or at the grocery     flow state.                                  percent commitment, you’re
     playing and we feel bad about            store, picking your child up after                                                    leaving room to negotiate your
     ourselves, which causes us to seek       school or extracurricular activities,    The idea of meaning and purpose.             way out of doing something, but
     more pleasure, more distraction. It’s    or waiting at a stoplight — these        The average person is interrupted            when you fully commit to a tiny
     a modern cycle of addiction.             are all perfect opportunities to         more than 100 times a day and                habit and you respond to the cue
                                              stop, take a four-by-four breath and     80 percent of these interruptions            you’ve established, you will be
     While all humans share these three,      center yourself.                         are self-imposed. But, it’s hard to          successful.
     potentially limiting, basic biological                                            be purposeful about your work
     realities, we also have the capacity     The idea of engagement.                  or to not feel anxiety over a to-do
     to change how we respond to our          Engagement is anchored in                list that never gets done when
     surroundings and current situation.      the concept of flow, which               you live in a state of interruption.
     Remember neuroplasticity?                was first identified by Mihaly           Thanks to neuroplasticity, we can
     Consider the following concepts          Csikszentmihalyi. Flow represents        train ourselves to become more
     that can help us change how we           the state we’re in when we’re            focused and purposeful in our daily
     respond to stressful situations or       doing work that is hard enough and       work. The idea that we can agree
     potentially harmful environments.        ambitious enough that we have            to attend to the things that matter
                                              to pay attention, but not so hard        and that we can train our brains
     The notion of being present.             that we get frustrated. When we          is a wildly optimistic message for
     One of the simplest things we            function in this state, studies have     health and well-being professionals.

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