When was the last time you had someone from IT help you solve a particularly annoying software problem? For me it was yesterday. Well, as you listened to the solution and if you didn’t write down the instructions or practice the fix several times, what is likely to happen the next time you run into that same problem? It won’t be pretty. I am sure you too have learned that the key to using new technology is taking the opportunity to practice.

Unfortunately much of life follows this pattern and wellness skills aren’t an exception. In the language of AMSO, the “O” represents “Opportunity to practice the new wellness behavior.” If our workplace wellness programs are not giving people clear opportunities to practice new healthy behaviors and refine skills then they are not likely to adopt these new behaviors and actually change their long term health behavior. And remember: no behavior change –> no health improvement –> no economic/measurable impact –> in no time you have no program!

Practicing skills gives allows us to do something enough so that it begins to feel familiar and natural. In the process of getting familiar we learn how to overcome little things that will otherwise grow into real resistance to performing the new healthy behavior. Unfamiliarity is often an enemy of behavior change because it can create uncertainty, fear or increase the perceived personal “cost” associated with overcoming that which is unfamiliar.

An opportunity to practice gives us an entry point to a new skill like healthy meal planning, adding a walk to our daily routine, or core strength exercises that prevent back pain. Opportunity can depend entirely on individual action or it can harness the social power of having others involved. It can also include feedback loops such as recording or tracking a behavior or using wearable tools like a Fitbit.

How many opportunities to practice are necessary? There isn’t hard science on this but the more the better! People will self-select into these opportunities but we want to provide enough options so that no one fails to change for lack of opportunities to practice. Also many wellness behaviors are carried out once every year or three, such as a preventive screening. In the case of episodic behaviors we probably want to make sure we have reminder systems in place.

The critical thing for us to remember about AMSO is that the opportunity to practice needs to be repeated often enough to lead to the formation of a habit. Habits are really the result of our consistent intention multiplied by the number of opportunities to practice. Habits are powerful and need to be cultivated and re-cultivated over time. We are actually trying to build a whole constellation of healthy habits in the individuals we seek to serve with our wellness programs.

Here ways that our wellness programs can provide the opportunities for practicing a new health behavior:

• Tip #1 – Embed the practice experience into the program activity: Regardless of the type of wellness program activity always include a practice session (or sessions!) into the activity. If it’s an educational session like a lunch and learn have part of the time dedicated to actually doing or practicing the specific activity to the maximum extent possible. Demo everything always including websites, YouTube videos, wellness coaching calls, health advice lines, stretches, specific exercises, stress reduction strategies, and testing.
• Tip #2 – Emphasize explicitly the formation of habits in all programs: Make explicit the discussion about tips for forming healthy habits. Talk about relapse prevention and behavior modification to help participants form consistent habits. The overriding concern of the wellness program should be habit formation not just the one time performance of a specific health behavior. Provide tools for participants that are intended to help them form those long term habits.
• Tip #3 – Plan follow-up sessions that emphasize practice opportunities: For each formal wellness program activity provide a follow-up practice session where it makes sense. Using experiential learning to its maximum extent always plan a week later session or month later session and label them “follow-up practice session”. Give people an opportunity to reconnect with the skills.
• Tip #4 – Actively link people who want to practice the same new behavior: Create or utilize social networking technology to help aggregate people who are working on the same health behavior change so that they can practice the new behavior together.   This method works well with walking, group exercise, fitness facility use, nutritional learning experiences like grocery store walk-throughs, healthy pot-lucks, watching LMS modules together with discussion afterward, healthy vacation options, stress reduction technique practice, humorous movies, chair massage, and many others.
• Tip #5 – Orient wellness coaching to focus on practicing the new behavior: Have wellness coaches focus on helping the individual structure practice sessions for the behaviors they are working on. They should formulate personal wellness objectives that emphasize practice. Look for ways to suggest practice opportunities that can be piggy-backed into the person’s average day. If the wellness coach is asking consistently about practice experience of the individual it is likely to have a stronger behavior change impact on the individual.
• Tip #6 –Use criteria in wellness incentive programs to emphasize practice: We believe that a long term wellness incentive program linked to $600 to $1,200 of reduced health plan contribution levels tied to a variety of wellness criteria is a necessary end game strategy for all Results-Driven Wellness programs. These incentive criteria can be crafted to encourage practice of healthy behaviors. The criteria can also be constructed to provide formal opportunities for practicing specific behaviors. The individual criteria can have alternative ways of being met and can include practice considerations.
• Tip #7 – Use annual wellness incentive programs to draw people back to selected wellness practices: The core long term wellness incentive program can also be used to call individuals back into wellness behaviors and to practice sessions. This overall process is what we call an annual opportunity to “get on the Wellness bus.” This calls people back to practice opportunities.
• Tip #8 – Start acknowledging people who have formed a new healthy habit: Just as many wellness programs do write-ups about people who have accomplished a significant wellness event, such as hiking through the Himalayas you can also do write-ups of people who have successfully developed a new wellness habit. If you set the definition of a “habit” as a full six months of a minimum level of behavior change then you can acknowledge those individuals and give an impetus for people developing a new habit.

This focus on structuring opportunities to practice the new skills and new behaviors needs to be intentionally built into every aspect of your program. At the same time you need to constantly work to bring new ways to help people change by helping them practice the new behavioral skills and develop those healthy habits.

Next time we’ll look at the new initiative of the Health Promotion Advocates to bring wellness and health promotion to every American.

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

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