Leveraging Behavior Change Theories in Program Design Improves Workforce Health
Authors: Davis-Street Janis , Johnson Allyson , Steinberg Michael 
Published: March 2020

Abstract

Background
Influencing health behaviors is the primary goal of health and wellness programs. Behaviors, in turn, both shape and are shaped by the social environment. Thus, creating an environment conducive to behavior change is important to effectively enable and encourage healthy behaviors. Creating healthy physical and social environments enhances behavior change programs by addressing change at multiple levels - individual, interpersonal, group and community. Such programs seek to impact knowledge, beliefs, and skills. While enhancing health awareness is important, understanding health behavior change models/theories as part of program design and implementation is critical for effective programming and communication.

Objectives/Scope
Using examples from our workforce health programs, we describe how behavior change theories have been used effectively in health promotion programs to improve workforce health. In addition, we identify success factors for health communication, program design and implementation in deploying global health programs.

Method
We present assessments of population health programs implemented to impact communicable (HIV/AIDS, TB and malaria) and non-communicable (cardiovascular disease and diabetes) diseases. Program design elements and communication strategies associated with Healthy Heart, diabetes awareness and peer health educator (PHE) programs will be mapped to behavior change theories to demonstrate their alignment with theoretical foundations. We will also describe the impact of implementing data- and theory-based communication best practices on program outcomes by evaluating health risks and aggregate health statistics.

Results and Observations
Health communication is most effective when messaging is simple, clear, concise, appropriate, understandable, and aligned with behavior change theories. Targeted programming can be optimized by addressing stages of change, providing cues to action, and promoting self-efficacy and motivation. Health awareness opportunities for communicable and non-communicable diseases increased as demonstrated by growing participation numbers. Health risk factors among participants were also positively impacted. For both communicable and non-communicable diseases, health programming utilizing PHEs supports the importance of social connections in enhancing the delivery of a variety of health messages, by being personally and culturally relevant and building rapport. We describe how learnings from cardiovascular-focused and quarterly programming successes can provide insights for deploying future PHE efforts.

Conclusions
Communicating risk at work is not limited to hazardous, occupational, or public health emergencies. Communicating to the workforce about health risk as part of well-designed programming is also critical for enabling workforce health, safety and productivity. Leveraging data and health behavior theory in communications and program design can positively impact health and wellness program participation, engagement and outcomes which in turn, impacts the safety of our workforce

Applications
Communication campaigns and wellness programs that are based on sound behavior change theory can successfully impact workforce health. We describe success factors for practical deployment in the energy industry and for enhancing peer to peer support of healthy behaviors.

Innovations or Technical Contributions
This paper highlights the value of considering the role of theoretical constructs in how people learn and how health behaviors change and persist.