When employers understand the transtheoretical model of behavior change they can take actions to help their employees in the best way possible. An awareness of each employee's readiness for change will enable them to be supported in a way that fits in with the stage they're at on their wellness journey. Ultimately, this results in better outcomes for both employers and employees when it comes to the success of a workplace wellness program. (Learn more in 7 Steps For Implementing a Workplace Wellness Program).
The stages of behavior change
1. Precontemplation
This is the first stage of behavior change, and it occurs before the employee has even started thinking about adopting healthier behaviors. They may not think there is any need to change, and they are not actively thinking about doing anything differently.
At this stage they may seem disinterested in your wellness program. They might not think that they need it and that they are fine the way they are, irrespective of their health status. Education and awareness around wellness could be lacking. Perhaps they even have strong beliefs around why they don't need to change.
2. Contemplation
By this stage, your employees have the intention to change to healthier behaviors. They want to change and they understand many of the benefits that a focus on wellness will bring.
There are likely to be a few barriers still holding them back in the contemplation stage because they haven't yet prepared to take action. Change can be hard and they are still weighing up whether the change will be worth it.
3. Preparation
The employees in this category are ready to change and are planning to do so within the next month. They might still be a little scared of failure but they are taking actionable steps to plan and prepare to lead a healthier lifestyle.
At this stage your employees might purchase a gym membership, even though they haven't started going yet. Perhaps they will buy a new pair of walking or running shoes, and they will share their intentions with friends and family. They might even try to encourage others to join them.
4. Action
Employees in the action stage have started on new, healthier behaviors sometime in the past six months. They may have joined your wellness program or a gym. They're doing things such as eating healthier, exercising, or maybe taking part in a tobacco cessation program.
They're still working on solidifying their behaviors and turning them into habits. At this point they're not quite on "autopilot" with the new behaviors but they will be starting to feel some of the benefits of their new focus on wellness.
5. Maintenance
By this stage, your employees have maintained their healthy behaviors for at least six months. Perhaps they've given up smoking and haven't gone back to it. Overall their healthy behaviors have become habits over time. These could be behaviors around exercise habits, healthy eating, or stress reduction, for example.
6. Relapse
Relapse can happen at any time, even in the maintenance stage when healthy behaviors appear to be established. Relapse involves reverting back to old behaviors. New barriers will always come up and slip ups are somewhat inevitable. Without adequate planning, support and intervention strategies, employees may end up "falling off the wagon" completely.
How employers can support employees through each stage of change
Once you have identified what stage of change an employee is at for a particular behavior, you can take steps to support them effectively. This will help them move closer to their health, fitness and wellness goals. It will also highlight your workplace wellness program as a worthy investment. (Learn more in Wellness Program ROI: Are Wellness Programs A Good Investment? and Encouraging Employees to Achieve Healthy Eating and Fitness Goals in the Workplace.)
Here are a few ways to support employees in each stage:
1. Pre-contemplation
- Ask employees questions to prompt them to think about their health. For example "what sort of health scare would you need to have in order to make a decision to be healthier?"
- Come from a place of understanding. Rather than judging, be curious and ask them questions. Develop rapport and trust so they will be more likely to listen and open up to you.
- Provide information about the benefits of healthy behaviors. Gently educate.
2. Contemplation
- Continue to ask questions, this time recognizing that they are interested in changing. "What sort of things could get in the way of you making a change?" "How would your life be different if you made these changes?"
- Encourage employees to move closer towards the planning phase. What things do they need to do to get closer to taking action?
3. Preparation
- Help employees with motivation as they move closer to getting started. Encourage them to write down and share their goals.
- Provide all the information they need to make a decision. For example, that could include information about gym memberships, coaches, and other people and services that could form part of their support team.
- Be excited for them — they will feed off your interest and excitement!
- Help them to create an intervention strategy. What will they do during the action phase when barriers pop up and slip ups occur?
4. Action
- Provide ongoing support and encouragement to keep the momentum going. Congratulate them on the actions they are taking to improve their health, and actively take an interest in how they are doing.
5. Maintenance
- Provide incentives or rewards for achieving and maintaining healthy behaviors, or ask employees to set and carry out their own rewards.
- Focus on continuing with positive behaviors. This might include forming a supportive group to help keep employees on track with their wellness goals. Reinforce successes and periodically check in and review that things are still going well and are in keeping with their overall goals. If goals or personal situations change, then pause and tweak the plan as needed.
6. Relapse
- Don't be hard on employees who relapse. This is when they need the most encouragement, empathy and support. Make sure that they recognize a slip up is normal and temporary and that things can get back on track. They haven't lost all the good work they've put in prior – when they do get back on track it will be easier to do so the second time around.
- Ask questions such as "What went wrong?" 'What needs to be done differently next time to prevent this from happening again?"
- Go back and re-visit goals. Check they are still the same, or revise as necessary. Once they are clear on and excited about what they want to achieve, take them back to the preparation phase so they can get ready to get back into action.