Well designed and implemented disability management programs can shorten or prevent employee absences, improve quality of life and productivity and reduce employer and healthcare costs. On May 25, approximately 100 plan sponsors, group insurers, benefits consultants, pharmaceutical representatives and other stakeholders met at Toronto’s Fairmont Royal York Hotel to discuss effective disability management strategies.
A change for the better
Thanks to medical science, we now have a wealth of information and interventions to keep us healthy. But the efficacy of medical interventions is in no small way mediated by behaviour (for example, drugs are ineffective if the patient does not take them). In his presentation, Dr. Michael Vallis, director of Capital District Health Authority in Halifax and a professor at Dalhousie University, explained the challenges of behaviour change interventions.
“Healthy behaviour is abnormal behaviour,” said Vallis. Consider that in Nova Scotia, 67% of the population is overweight or obese. “It is now statistically abnormal to be at a healthy weight in Nova Scotia,” he said. Similarly, people who are routinely physically active are in a small minority.
Our tendency to avoid healthy choices isn’t surprising given that our two primary motivators are pleasure and (avoidance of) pain. Fast food, alcohol and drugs feel good; working out (at least in the short term) feels bad. Add in socio-biological factors that promote food as comfort and our obesigenic environment that discourages activity, and it is easy to see “there a lot of good reasons not to change,” said Vallis.
Power of change
On the other hand, the power of change is well documented. Two landmark trials in the area of prediabetes, for example, clearly showed that people who improved their lifestyle could delay the onset of diabetes at rates better than people who took medications. “Yes,” he said, “change is hard, but these studies validate the role of behaviour change.”
Behaviour change counselling—which is a combination of motivational interventions, behaviour modification and emotion management interventions—is a patient-centered counselling style that can be helpful with those who are reluctant to change, who routinely encounter barriers that impede change or who are ambivalent about increasing healthy lifestyle behaviours. Such counselling can be challenging in a work environment, however, where a predetermined “us-versus-them” dynamic often creates barriers.
Employer role
The employer’s role is to identify employees who have unhealthy coping strategies and are in need of behaviour change counselling; educate employees and recommend resources; and support staff in their change efforts, he explains.
As an example of a workplace that supports healthy choices, Vallis pointed to his own employer, Capital Health, which recently announced that high-fat donuts and muffins have been banned from the onsite coffee shop.
The goal of Vallis’ presentation was not to make people experts in behaviour change counselling, but rather to raise awareness of the challenges and strategies facing us all. “If you are mindful of these issues, it may make it easier for the individual to choose behaviour change,” he concluded.