By Gianna Biscontini, M.A., Ed.H.D., BCBA
Biscontini Behavior, LLC
Public health issues once thought to be individual and separate from the workplace now pose a global threat to organizational bottom lines, family functioning and individual wellbeing. An 11-hour increase in the typical work week paired with a decline in vacation hours taken over the last four decades (Schulte, Connolly and Ung, 2017), means less time spent enjoying social relationships and family time and more hours at work, where task overload and packed schedules threaten stress levels and positive health behaviors like a proper diet and exercise. This begs the question: If our work is negatively affecting our health, can we as analysts help position companies to be public health heroes?
The data from global giants like the World Health Organization and World Economic Forum, in addition to work from up-and-comers like Ideas42, is alarming. Recent studies show a relationship between work-family conflict and unhealthy eating habits, obesity, elevated cholesterol levels, and hypertension (Moen, Kelly, Tranby & Wong, 2011). According to research by Towers Watson (2015), a workforce provided with effective health and productivity strategies can reduce costs by more than $1,600 per employee in reduced sick days. A meta analysis of 228 studies in Behavioral Science and Policy examined effects of workplace stress and health outcomes, finding that job demands increased physician-diagnosed illness by 35% and long work hours increased mortality by 20%. Our public health crisis is clearly in need of scientific intervention. In addition to the benefits of creating a workplace where employee health actually improves, we can also expect extrapolated benefits of a health-centric workplace through behavioral cusps.
Cooper, Heron and Heward (2006) define a behavioral cusp as “a behavior that has sudden and dramatic consequences that extend well beyond the idiosyncratic change itself because it exposes the person to new environments, reinforcers, contingencies, responses, and stimulus controls”. An addition from wikipedia notes, “It affects the people around the learner, and these people agree to the behavior change and support its development after the intervention is removed”. Small change leads to bigger change, which leads to culture change, which leads to global change. Sounds like a public health revolution to me.
As scientists, we offer up unique and valuable perspectives to other disciplines interested in change. A strong, comprehensive analysis of a workplace can aid in understanding the ways in which our work contributes to illness and unhealthy behavior by identifying the variables that influence us. Through collaborative efforts we can take data, collect biofeedback, develop behavioral and environmental change programs and ensure sustainability. We can use OBM to help answer questions like, “Does investing in my employees’ health provide me with positive business outcomes?” Interestingly, organizations are beginning to turn the tides and invest in their employees like never before. Google, Aetna, General Mills and Target have joined the corporate giants in pioneering mindfulness programs for employee benefit packages, with significant financial returns as a result. Amazon, JP Morgan Chase and Berkshire Hathaway are hatching a plan to disrupt the healthcare industry by starting an innovative, cost-effective and transparent healthcare company for their combined 1.1 million employees. This is the influence leadership has on behavioral contingencies in the workplace- also known as culture (heard of it?). If poor leadership has the power to take a company down- and it does- then modern, health-centric leadership has the power to improve the workplace in measures beyond bottom lines.
These 4 preliminary steps to leading a health-centric workplace are offered in an effort to create change in ourselves, so that we access firsthand the reinforcing contingencies of prioritizing health as an organizational value. Leaders can then take charge and evoke health-related work behavior in employees, backing it up with reinforcing consequences that solidify a new culture and updated values.
Make time for data: Set aside 30 minutes a day for 3-5 days and observe the culture surrounding health in your workplace. How big is the gap between what is said to be valued and what is actually valued as demonstrated by contingencies at play? Give extra attention to those small to moderate tasks over which you have control. If you’re, say, a surgeon, and thinking “Well, operating on people causes me health-debilitating stress”, you’re clearly in the wrong field (and yikes). But if less healthy scenarios are sprinkled throughout your job (i.e., occasionally working late, frustrating meetings), it’s much more likely that you have at least some part in modeling change through leadership.
Be honest– What do you love most about your workday? What do you loathe? Marcus Buckingham (Gallup, StrengthsFinder) conducts this exercise with his clients to aid them in leveraging their workday activities. In other words, what tasks give you and our staff energy? What tasks leave you and your staff feeling exhausted (“stress” isn’t a good measure here, as it’s just too involved for this short exercise)? Honesty is important, as you are working on isolating complicated variables and the accuracy of your results is critical for effective change. If you’re loathing tasks, chances are others are, too. These tasks are your starting point.
Go full nerd– After gaining some insight into your work tasks, fill out a scatterplot (or data instrument of your choosing). What times of day are you the most energized? The most tired? This will help you check your previous (subjective) thinking which can neglect confounding variables (beware of confirmation bias!). If you find yourself exhausted by (i.e., loathing) Monday afternoon meetings- nodding off, feeling irritable, losing your attention- is that solely during Monday meetings or could it be the time of day? Or does it depend on meeting content? Or your exercise history that day? Taking some supplemental data is a decent check for otherwise private behavior that is sometimes difficult to measure objectively. Just as you would look further into the behavior of a pediatric client (Are they on medication? How was school? Did they have sugar before that meltdown?) our workplace behavior deserves the same careful analysis. Our brains are wired to create quick, convenient explanations for why we feel certain ways, which can lead to a confirmation bias, which then becomes a false rule on which we direct our future behavior (i.e., “I get tired during meetings because I am bored so I avoid them whenever possible” Are you sure?).
Be a boss– What tasks do you control for yourself and your staff throughout your day? Of those tasks, what can be modified so that you or your staff find them more enjoyable and in line with healthy behavior? If meetings with your boss are your (or your staff’s) number one “loathe”, take responsibility. As behavior analysts we know that there is very little we have absolutely no control over, especially if we understand the full scope of the variables involved. If your meeting time occurs when you’re generally tired anyway, can you change it? If meeting in person and making a long drive leaves you irritable, consider moving to a phone meeting or taking a walk beforehand. If the problem is hearing (or giving) constant negative feedback that leaves you wanting to crawl in a hole and die, that’s a good sign this situation is 1) significantly wearing on your health and 2) an opportunity to advocate for healthier, more productive, more enjoyable solutions. To make this more motivating, I can offer readers some comfort here. I have never, ever heard anyone I respect state that they prefer to be in the dark on how their employees feel. Good leaders are open-minded and most likely want the feedback, especially if it’s affecting your productivity, engagement and/or health. Stuck with one of the few bosses uninterested in your feedback or health? It’s time to find one who invests in you.
This opportunity for behavior analysts, stacked with social impact and meaningful change, has never been more within our reach. Behavior analysts think big and we think differently. An apple a day is progress. Lowering blood pressure by building health-centric cultures, reducing stress by crafting better performance feedback processes and integrating healthy behavior with OBM strategies to improve employee and organizational health is changing the game.
Caver, K., Davenport, T.O., Nyce, S. (2015) Capturing the Value of Health and Productivity Programs. Organizational Health and Wellness, v.38 (1)
Cooper, J.O., Heron, T.E., and Heward, W.L. (2006). Applied Behavior Analysis (2nd edl). Upper Saddle River, NJ: Prentice Hall
Goh, J., Pfe er, J., & Zenios, S. A. (2015). Workplace stressors & health outcomes: Health policy for the workplace. Behavioral Science & Policy, 1(1), pp. 43–52.
Moen, P., Kelly, E.L., Tranby, E., & Huang, Q, (2011). Changing Work, Changing Health: Can Real Work-Time Flexibility Promote Health Behaviors and Well-Being? Journal of Health and Social Behavior, 52(4), 404-429.
Schulte, B., Connolly, D., and Ung, U. (2017). Better Work Toolkit. Can be found at https://na-production.s3.amazonaws.com/documents/The_Better_Work_Toolkit_-_Final.pdf
Gianna Biscontini, M.A., Ed.H.D., BCBA is a behavior analyst, writer, speaker and the founder of Biscontini Behavior, LLC, a behavior analytic, health-focused organizational consulting company. She has worked in the field of behavior analysis since 2005 in clinical, educational, leadership and consulting roles with children and adults. After graduating from George Washington University, Gianna began her post-graduate career under Washington D.C’s then-Chancellor, Michelle Rhee, and former mayor, Adrian Fenty, in the Central Office of Special Education. Gianna spearheaded a keystone project to develop the city’s first early childhood autism evaluation team, served as a panel contributor at her alma mater and at Princeton University and presented her pediatric work at the Health Services for Children with Special Needs, Inc. conference. She served 5 years on the board of directors for The Bowen Foundation for Autism and has written several articles for EP Magazine (formerly Exceptional Parent). After moving to San Diego for a clinical leadership position in a large NPO, Gianna expanded her career into organizational behavior. As an associate consultant at the Leadership Research Institute, she developed behavior-based programs on conducting difficult conversations, fostering critical thinking skills and engaging in entry- to senior-level leadership behavior. She received her certificate in Organizational Behavior Management from the Florida Institute of Technology in 2017.
Gianna’s current work is focused on using behavior science, neuroscience-supported mindfulness and OBM strategies to alleviate public health concerns like stress and task overload by redesigning and modifying workplaces to adopt health-centric cultures. Gianna continues to work on collaborative projects with fellow entrepreneurs in an effort to disseminate innovative applications of behavior analysis to a wider audience. She can be reached at email@example.com.