I recently read Dr. Michael O’Donnell’s article in the “American Journal of Health Promotion,” titled “Four Lenses Through Which to Develop Wellness Incentive Policies.”
The incentive parts for the ACA law were based on positive ROI data for a wellness program that did not exist. (Read about the Safeway Amendment.) As much as I respect Dr. O’Donnell and find areas of agreement with him within health promotion, I can’t understand his tolerance for the use of extrinsic incentives in workplace wellness programs when they are clearly refuted by science.
So, here’s my simple question:
Is there any single, credible study, published anywhere, in the last 15 years that demonstrates incentives result in long-term behavior change?
Amazingly, some people in the wellness business seem to think the jury is still out on this question. Even at my C+ grade level, I can find a ton of great documentation that not only indicates extrinsic incentives do not have any long-term benefit, but that they also harm intrinsic motivation. More books and papers than I could read in a year show the harm of extrinsic incentives. But not one, single, solitary study suggests extrinsic incentives can change long-term behavior for the better. Not one! Anywhere! Period!
The jury is still out on the degree that extrinsic incentives harm intrinsic motivation. It’s going to be a lot more than we think. If you’re trained in workplace wellness, or interested in developing a healthful workplace culture, you’ll never make lasting behavior changes until you stop using incentives (carrots or sticks). You need to stand up, and advocate for their demise. Now, if you’re in a place that will not allow you to do that, I’d say you may work in a toxic culture yourself.
Shawn is the President and Founder of Hope Health. For over 30 years, his work has focused on bringing clear, easy-to-read and watch health messages to the public via workplaces. He bills himself as the “Best C+ Student in the Wellness Biz” because, as he says, “I like to challenge the notion that there is no such thing as a stupid question.” Shawn is on a mission to tie workplaces into their surrounding communities to share resources and ideas in an effort to improve the health of all Americans.
You may reach Shawn at sconnors@HopeHealth.com or 800-334-4094.