The workplace represents an ideal environment to promote health initiatives because most adults spend a majority of their time at work. The Community Preventive Services Task Force, composed of public health and prevention experts, promotes using worksite health promotion (WHP) programs to improve diet and physical activity behaviors to manage employee weight (1). WHP programs incorporate a combination of educational, behavioral, social, and policy strategies to elicit approximately a 2.8-lb weight loss during the course of 6 to 12 months (2). Although this amount of weight loss seems to be modest, when applied to a large proportion of the employee population, it can potentially assist in the prevention and treatment of overweight and obesity in the workplace (7). Worksite competitions have been used as approaches within WHP programs to assist individuals in the adoption of healthy behaviors to initiate and maintain weight loss.
Competitions incorporate behavioral strategies such as self-monitoring, goal setting, and reinforcement. For example, participants self-monitor their progress toward achieving targeted goals related to health behaviors (e.g., minutes of moderate-intensity exercise) and are rewarded with tangible incentives such as t-shirts and gift certificates. Incentives are offered to increase participation, compliance with behavior change recommendations, and achievement of certain goals (14). In addition, competitions can be developed to have a theme tied to the targeted behaviors that are relevant for participants (e.g., step goals to reach popular destinations). Previous studies have demonstrated that competitions increase participation in WHP programs, are associated with lower attrition rates, result in significant behavior change (e.g., increased physical activity), and improve weight loss outcomes (3,5). The structure of the competition also influences effectiveness.
Individual and team competitions have been used within WHP programs designed for weight loss and physical activity. For example, Cohen et al. (5) examined the impact of team weight loss competitions on the success of a WHP compared with an individual competition. The results showed that weight loss was greater in the team competitions compared with that in the individual competition. Furthermore, the individual competition had a 17% attrition rate as compared with 0% and 3% for the team competitions, respectively. Similar findings were reported by Blake et al. (3) when examining team competitions for increasing physical activity behaviors. Therefore, team competitions result in significantly lower attrition rates and improve health behaviors in comparison with individual competitions (3,5). It seems that teamwork, within the context of friendly competition, may provide additional social support and motivation to achieve health outcomes in a workplace setting. Overall, to achieve successful health behavior change, a competition is recommended to be creative, well planned, and interactive while providing participants with support to engage in healthy behaviors. Thus, it is of importance that health and fitness professionals and employers understand the key steps to consider when organizing worksite competitions to promote the adoption and maintenance of health behavior change for weight loss.
KEY RECOMMENDATIONS TO CONSIDER WHEN ORGANIZING WORKSITE COMPETITIONS FOR WEIGHT LOSS
The following list contains key recommendations to consider when organizing worksite competitions to promote positive health behavior change related to weight loss:
- 1) gain support from the organization
- 2) identify a key health behavior to target (e.g., physical activity, caloric intake)
- 3) determine how to measure the key health behavior
- 4) develop the competition structure
- 5) establish an appropriate time frame for the competition
- 6) choose a creative theme, incentive, and marketing strategy
- 7) develop effective communication strategies with participants in the competition
- 8) plan to evaluate the success of the competition for promoting behavior change
- 9) reward individual and group achievements
- 10) sustain momentum for long-term health behavior change
STEP 1: GAIN SUPPORT FROM THE ORGANIZATION
Gain support from the organization to develop a worksite health and fitness competition. Support may come from senior-level management, mid-level management, or employee wellness committees, in which representatives from various levels within the organization provide direct employee input. Senior-level management often controls the budget and assists in developing, implementing, and evaluating program outcomes. Whereas mid-level management and employee wellness committees often serve as competition “champions” and promote employee participation. For example, they can lead group walks, kick off events, and promote participation by endorsing the competition. If employees view members of management and wellness committee members as being committed to living a healthier lifestyle, they are likely to follow the lead.
STEP 2: IDENTIFY A KEY HEALTH BEHAVIOR TO TARGET
What health behaviors are most valuable to target? This requires an understanding of what impacts the health of employees at the worksite (e.g., diet, physical activity, body weight). Thus, conducting a workplace health assessment is a necessary step.
To conduct a workplace health assessment, it is important to determine which data are available for use. For example, many organizations offer employees surveys such as health risk appraisals to assess health behaviors. Assessment of health risks may be of interest because they are easy to administer (Web-based versions are available), convey a lot of information quickly, allow for access to a large number of people, provide workforce-wide estimates, and allow the potential for follow-up (13). If these data are unavailable, consider reviewing employee health care claims, health care benefits, demographic data, and outcomes from previous initiatives. Once the health risks of the population have been identified, the health behavior to target during the competition can be determined.
STEP 3: DETERMINE HOW TO MEASURE THE KEY HEALTH BEHAVIOR
Research has shown that self-monitoring is an important strategy to improve health outcomes for individuals because it promotes behavior change such as increasing physical activity and decreasing caloric intake to induce weight loss (4). Examples of self-monitoring tools include paper diaries, Web sites, mobile phone applications, and calendars. Incorporating self-monitoring tools within a competition allows the assessment of the participant’s progress toward achieving the specific outlined goals while allowing the staff the opportunity to collect evaluation data.
To choose a self-monitoring tool for the worksite competition, determine which resources are available and if it is appropriate for the organization’s population. For example, if most of the employees do not have access to the Internet, a simple paper tracking tool may be best. Conversely, if participants would prefer to track behaviors on a Web site, consider how to obtain these data (e.g., some Web sites allow additional access to outside parties or the participant could print out a report to turn in or email to staff). Developing a tracking tool specific to the competition (as illustrated in Fig. 1) can decrease the load and cost of data management for staff. The self-monitoring tool also can be sent to a secured email box each week before a specified deadline (e.g., Monday at noon) to track progress toward behavior change (e.g., increasing physical activity) and to determine who receives the final competition incentive.
Those implementing the competition can train and assign a competition “champion” from the worksite to provide feedback and reinforcement based on the reported behavior change. For example, if a participant is struggling to achieve his or her physical activity goal, the competition champion can offer ways to overcome barriers to exercise, such as incorporating short bouts of exercise throughout the day. Participants will have the opportunity to modify behavior change over time while increasing their self-efficacy as they seek to reach desired goals (6). Furthermore, the participants will know that their efforts are not going unnoticed, and this may increase motivation for long-term behavior change.
It is also important to provide participants with the means to accurately and frequently assess their progress toward behavior change goals (12). For example, if the goal is to improve overall physical activity levels, participants can be given a pedometer in conjunction with a weekly step goal to achieve. If the goal is to improve diet behaviors to induce weight loss, provide participants with a calorie-counting tool and a calorie goal to work toward.
STEP 4: DEVELOP THE COMPETITION STRUCTURE
Consider developing an individual and team competition. The individual division can be for participants who are interested in changing their behaviors at their own pace and comfort level. The team division can be for participants who would like additional motivation from their team members to achieve their goals within the constructs of social support. Currently, there are no definitive data to determine how many participants should be assigned to a team in a worksite competition. However, previous research has shown that recruiting three friends or family members for social support was associated with greater weight losses and decreased dropout rates compared with when individuals were recruited alone (15). Therefore, it is recommended that teams consist of three to five members. This allows for adequate social support without overwhelming the participant. However, each worksite can choose the number of team members that is best suited for their working environment.
Once the competition structure is determined, develop the competition rules and goals. Goal setting is an effective strategy to promote physical activity and dietary behavior change in adults. Goals should be specific, challenging, yet attainable, and correspond to targeted health behaviors (6). For example, if the competition is targeting an increase in physical activity, set a goal for participants to modestly increase the amount of minutes spent at moderate-intensity exercise each week. Furthermore, the feedback given by a competition champion can allow participants to determine whether they are approaching goal attainment, thus building their self-efficacy for achieving the behavior change while increasing motivation (6). To reduce any confusion and lead to a much more enjoyable experience, provide a participant overview (as shown in Fig. 2), which states the rationale of the program, weekly goals, competition calendar, and a clear explanation of how they can earn the competition’s incentive. Allow members of management and the wellness committee to review the rules and give you feedback to ensure that they feel that the rules are fair and will work within the organization. Furthermore, obtain their insight as to what aspects of the competition will appeal to employees. On receiving approval, distribute the participant overview well in advance of any registration opportunities to address any questions or concerns before beginning the competition.
Last, consider developing a health waiver for participants to sign before beginning the competition. If the organization has a legal representative, discuss the use of appropriate screening tools related to the targeted health behavior such as the PAR-Q (Physical Activity Readiness Questionnaire) (10). This is used to determine if the employees are safe to participate in a competition that focuses on physical activity.
STEP 5: ESTABLISH AN APPROPRIATE TIME FRAME FOR THE COMPETITION
To assess progress toward achieving the targeted health behaviors while maintaining the participant’s interest, establish an appropriate time frame for the competition. When developing the competition calendar, anticipate potential barriers that may hinder the participant’s ability to adhere to the outlined competition goals. For instance, holidays and vacations may require some flexibility. In addition, some individuals may travel for work and may not be able to turn in or email their self-monitoring tracking tool of the targeted health behavior to staff. Thus, developing a predetermined plan will allow these participants to stay engaged while maintaining the integrity of the competition.
Determining the best time of the year to offer a competition is also extremely important. For example, some organizations have different times that they take inventory or get audited. Thus, it may not be ideal to implement competitions during these times because many employees are often overwhelmed with work. Furthermore, activities within competitions such as group walks also should be scheduled at times that are convenient for all participants (e.g., lunch time).
STEP 6: CHOOSE A CREATIVE THEME, INCENTIVE, AND MARKETING STRATEGY
The theme of the competition is recommended to be creative, fun, and appeal to all employees. Themes could include world events (e.g., World Series, Olympics), destinations (e.g., walks to popular beaches), reality television shows, or be related to the time of year. For example, in January, many individuals are making New Year’s resolutions to lose weight. Therefore, it may be a great time to focus on behaviors such as reducing caloric intake and increasing exercise. Discuss options with the organization’s management and wellness committee members to determine what theme is best for the employees and incorporate overall health objectives of the organization if possible. In addition, an option is to use a poll, survey, or focus group of employees to determine what theme and targeted health behavior would be most appealing and appropriate for the population.
Once a theme has been determined, an incentive for the competition may be selected. Incentives can serve as cost-effective and enjoyable promoters of behavior change to assist participants in achieving targeted health outcomes. An incentive can be related to the competition theme such as a gift certificate for a pair of running shoes or a medal ceremony for an Olympic theme. Consider tying in an incentive for each week the participants achieve the specific goal (e.g., a raffle ticket to be entered into a weekly lottery drawing for an incentive competition-related item) to increase participation and retention efforts. The incentive could come from the organization or from an outside company looking to advertise its product (e.g., a trial gym membership at a local gym, gym bags, nutritional bars, etc.). Staff enthusiasm is critical to the acceptance and success of the competition for the participants. Therefore, staff can have fun with the theme and incentives while remaining encouraging and professional.
Now that a theme and incentive have been established, it is important to brand the competition through a marketing strategy that will increase participation and enthusiasm. Develop an eye-catching logo and competition name (e.g., Lose Weight and Feel Great), and approximately 1 month before registration, and each week thereafter, send strategic “teasers” to employees by an email, flyer, or postcard. Potential participants will have the opportunity to review competition requirements, and it will help generate interest.
STEP 7: DEVELOP EFFECTIVE COMMUNICATION STRATEGIES WITH PARTICIPANTS IN THE COMPETITION
Developing effective communication strategies will help motivate participants to stay engaged in healthy behaviors during the competition. Examples of communication strategies include:
- daily emails
- behavioral tip sheets
- motivational posters
Content related to the targeted behavior change goals also can be tailored and delivered in a timely manner. For instance, if the targeted health behavior is increasing physical activity and it is raining outside, consider sending an email on how to overcome weather as a barrier to exercise. Furthermore, use the information from weekly self-monitoring tools participants turn in to the staff to tailor materials to help those individuals who are struggling to adhere to new behaviors and/or encourage those who are succeeding. This will provide additional motivation and support to the participants as they work to establish the new behaviors.
STEP 8: PLAN TO EVALUATE THE SUCCESS OF THE COMPETITION FOR PROMOTING BEHAVIOR CHANGE
The final stage of organizing a worksite competition includes decisions concerning the evaluation of the competition’s success. Predetermined evaluation plans can help assess if the competition was effective in achieving significant health outcomes. Thus, review evaluation measures with the organization’s management before implementing the competition. Include presurveys and postsurveys about health behaviors to determine if the competition enhanced participants’ knowledge and if they are actively engaging in the targeted behavior. Also evaluate participation rates, satisfaction of materials/activities, outcome measures (e.g., precompetition and postcompetition weights), and the cost-effectiveness of the competition. This will allow management to evaluate if the competition was a wise investment and strengthen the case to continue developing and implementing worksite competitions. Qualitative data, such as stories of successful participants, also can be included in the evaluation process.
STEP 9: REWARD INDIVIDUAL AND GROUP ACHIEVEMENTS
Most importantly, acknowledge achievements of the participants as a group and recognize significant individual achievements. At a closing ceremony, award participants the incentive for achieving the outlined goals of the competition. In addition, consider rewarding participants who achieve an overall weight loss goal of the competition (e.g., 10 lbs). A variety of other incentives and awards can be given to recognize different levels of participation (e.g., best self-monitoring efforts, biggest percentage of weight loss).
STEP 10: SUSTAIN MOMENTUM FOR LONG-TERM HEALTH BEHAVIOR CHANGE
Congratulations! A successful worksite competition has been developed. Now what’s next? Having a long-term plan is crucial to maintain motivation for participants. Therefore, it is important to think about a comprehensive approach to worksite competitions to improve health behavior change throughout the entire year. Below is an example of competitions and themes that can be implemented throughout the calendar year:
- January through March: 8-Week Weight Loss Competition (e.g., target behaviors: diet and exercise; theme: “New Year, New You!”)
- May through July: 6-Week Fitness Competition (e.g., target behavior: exercise; theme: “Reach the Beach”)
- September through October: 8-Week Pedometer Competition (e.g., target behavior: steps within the context of improving overall physical activity levels; theme: “Step Into Fall”)
- November through December: 6-Week Holiday Competition (e.g., target behavior: daily weighing and exercise; theme: “Maintain, Don’t Gain”)
The goal is to help participants engage in multiple health behavior changes throughout the year to achieve a healthier lifestyle. Other ideas to sustain momentum include novel events (e.g., scavenger hunts, 5K races, cooking demonstrations), interoffice department competitions, or competing against other companies of related fields.
Worksite competitions can be effective strategies to engage employees in health promotion activities to improve weight loss outcomes. There are multiple components to consider when organizing competition to promote behavior change for weight loss. Overall, it is recommended that worksite competitions are simple, fun, and engaging. Moreover, sustaining momentum through follow-up activities is extremely important to promote behavior change for participants to achieve a healthier lifestyle long-term.
CONDENSED VERSION AND BOTTOM LINE
Worksite competitions have been used as approaches within worksite health promotion programs to assist individuals in the adoption of healthy behaviors to initiate and maintain weight loss. To achieve successful health behavior change, a competition is recommended to be creative, well planned, and interactive while providing participants with support to engage in healthy behaviors. Furthermore, sustaining momentum through follow-up activities is critically important to promote behavior change for participants to achieve a healthier lifestyle long-term.
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Keywords:© 2013 American College of Sports Medicine.
Health Promotion; Workplace Initiatives; Behavior Strategies; Planning; Incentives