Do you AMSO? Part 2 – “M” is for Motivation


Think about the last time you found yourself shopping for clothes. Looking over the multi-colored business shirts at Joseph A. Banks last week, though I needed a shirt, I wasn’t feeling that motivated to jump in and buy. Sensing my interest in the shirts, the saleswoman informed me about their current deal: three shirts for the price of two! So like magic I went from thinking I needed maybe one shirt to walking out with three!

Don’t you feel bombarded by deals, special incentives, and promotions? If the multi-trillion dollar retail marketplace uses these tricks to take latent intrinsic motivation all the way to a sale, why should we be surprised that we need incentives to trigger action in wellness?

The “M” in AMSO stands for Motivation. I was motivated by the deal to buy 3 shirts instead of 1. The tried and tested AMSO framework holds that effective wellness programs need to have multiple strategies for enhancing the intrinsic motivation for wellness that already exists in participants. In my experience about 20% of most populations are already intrinsically motivated to engage in wellness even before a wellness program is offered. The problem is that the other 80% usually aren’t motivated strongly enough to participate in a wellness program and often tend to ignore it, making the wellness program run the risk of looking (and being) unsuccessful.

Now some wellness advocates believe that if they can just talk to those in the 80% group they will eventually become intrinsically motivated to participate in wellness programs. However, I see absolutely no evidence in the scientific literature that anyone has ever sustained high short or long term wellness program participation by simply talking with people—more information doesn’t create motivation out of thin air. I believe that it takes an attractive “deal” to get more of those 80%’ers to engage.

The “deal” can be so many things–this is where you need to think out of the box.  It could be a sense of belonging, an opportunity to contribute, greater disposable income, a sense of achievement, fun, more time off, lower health plan costs, or dozens of other pay values. All of these types of “deals” represent extrinsic sources of motivation that are intended to augment the intrinsic motivation that innately exists in virtually all populations.

Once you have the 80%’ers participating you have an opportunity to work on converting the extrinsic sources of motivation to intrinsic motivation. Intrinsic motivation is absolutely what creates sustained change, but we need folks to get on the wellness bus in order to have a bite at that apple (more about that in another series of posts).

What kinds of strategies should you consider using to help reach the 80%’ers? Here’s what I recommend:

Step #1 – First, spend time learning about the 80%’ers. Find out what they think about wellness, what it means to them, and what do they know about why wellness makes sense for them. Typically this can be done through an interest surveys, focus groups, interviews, online chat rooms and open forums.

Step #2 – Next, ask about why they don’t find wellness very interesting or important. In your discussions with individuals and small groups ask about why they don’t see wellness as important. Use questions like: “What would it take for you to actively participate? What’s holding you back?”; “What do you see as the main barriers to taking better care of your health?”; “How important is your own well-being to you?”; “What kind of a “deal” would help you participate?”

Step #3 – Probe about what it would take for them to participate and authentically engage. When discussing wellness ask them questions like: “If you could feel better would you want to participate?” or “If you could pay less for your health plan would you be willing to participate?” Use ‘what if’ questions like: “What if you were part of a team? Would that appeal to you?” You want to get under how your 80%’ers feel about the following possible extrinsic reasons for participating in a wellness program:

  • Feeling and looking better
  • Receiving a sizable financial reward
  • Avoiding a significant financial penalty
  • Receiving more time-off from work
  • Getting a desirable material goods
  • Receiving a special privilege at work
  • Being recognized for an accomplishment
  • Being part of a team in a group competition
  • Being able to exercise some control and ownership over the program
  • Having access to wellness made easier
  • Having a personal role in feedback
  • Having something new to experience
  • Having an opportunity to gamble or win something
  • Having an opportunity to belong to a group
  • Having an opportunity to experience humor
  • Help in meeting a personal challenge
  • Enjoying fun and lightness
  • An opportunity to develop self-mastery
  • Experiencing a sense of acceptance or approval
  • Experiencing comfort
  • Having an ability to contribute to something bigger than yourself
  • Experiencing a creative outlet
  • Opportunity to be a good exemplar to others
  • Opportunity for high visibility or attention
  • Opportunity to avoid personal discomfort
  • Opportunity to meet and mix with managers

Step #4 – Combine 3 or 4 of the most popular extrinsic reasons into a long term incentive program. Select the extrinsic reasons of your 80%’ers that seem to be the most often mentioned into a reoccurring core incentive design. My experience is that a $100 a month lower health plan premium for several wellness achievements is one of the single most effective extrinsic reasons for participation in a worksite wellness program.

Step #5 – Look for ways to build as many of the other extrinsic reasons for participation into your program as possible. In addition to a formal incentive program I recommend that you look for creative ways to address several more of the most popular reasons cited by your 80%’ers associated with participation. Look to combine other popular “pay values” into other program interventions or short term incentives.

Step #6 – Communicate about all the extrinsic reasons with your entire population. Once you have selected your 3 or 4 core extrinsic reasons for participating and the other extrinsic reasons you select, keep communicating about them to your entire population. If employees and their spouses don’t know about the extrinsic reasons for participating in their wellness program then they are not likely to participate.

Step #7 – Create programs that convert extrinsic motivation to intrinsic motivation. This is a big topic In another series of posts I’ll be sharing about programming strategies for helping convert the extrinsic sources of motivation into intrinsic motivation.Step #8 – Rinse and repeat: cycle back around to fine tune your approach. Take the time each year to examine your “deals” or extrinsic reasons for participation and consider new or modified “deals” or pay values. Keep your novelty draw high with new challenges and new learnings.

Next time we’ll look at the “S” in AMSO a powerful framework for making sure your wellness program is producing results!

Don’t forget, strategies for using AMSO is a key area of emphasis in each level of certification in the WellCert Program!

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