according to a new survey by GFI Software, email is alive and doing well in small- to mid-sized america.

forty-four percent of respondents use email over other available channels, such as instant messaging (6%), face-to-face (22%), and phone (28%). they’re also quick to review and respond to email, with 76% of respondents replying within an hour of receipt and 32% within 15 minutes.

even after the workday is over, email checking is not. respondents report checking email at school events, weddings, even funerals or when their partner was in labor. (labor can go on forever, so that’s not as bad as it seems at first blush.)

almost every moment presents an opportunity to focus on what’s at hand or check our phone when it beeps—and even when it doesn’t.

our inability to ignore email has led some companies to shoulder the responsibility for shutting it down. atos, an international information technology company, has a zero email policy. the advisory board has a no after-hours email checking policy. other companies ban email on certain days.

these companies are reversing a condition that’s developed over time—intentionally or not—and is part of a larger problem. with each check of our email, we turn away from other tasks and lose our focus. this task-switching is something researcher gloria marks studies to understand its impact on productivity:

“Surprisingly our results show that interrupted work is performed faster. We offer an interpretation. When people are constantly interrupted, they develop a mode of working faster (and writing less) to compensate for the time they know they will lose by being interrupted. Yet working faster with interruptions has its cost: People in the interrupted conditions experienced a higher workload, more stress, higher frustration, more time pressure, and effort. So interrupted work may be done faster, but at a price.”

email bans may do for us what we can’t do for ourselves. with creativity, health, and well-being at risk, they may do much for the companies that implemented them as well.

find the full survey results here.

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a study conducted by the university of michigan health system and stanford university found that employees offered the choice to pay more or exercise more chose to get a move on.

according to the university of michigan health system’s website:

“Blue Care Network created a buzz when it implemented one of the largest-scaled financial incentive programs in the country by requiring adults who were obese and in the Healthy Blue Living program to enroll in a fitness program to qualify for lower out-of-pocket health care costs. Enrollees could choose between several programs, including Weight Watchers and WalkingSpree, which uses a digital pedometer to upload walking data on a wellness tracking web site.

“For some families, the out-of-pocket cost of failing to meet the new criteria in one of the wellness programs was nearly $2,000 more per year. Those with medical conditions were exempt if they had waivers from their doctors.”

5,000 steps per day required

the program was actually a little broader than described here. to save the $2,000 in reduced copayments and deductibles, BCN required participants to meet certain health metrics or enroll in a program that helped them move closer to doing so. participants with a BMI equal to or greater than 30 were invited to enroll in a weight management program or walkingspree’s internet-empowered walking program. they could also opt out or obtain a medical waiver. the study looked only at the experience of those who enrolled in the walkingspree program, roughly 50% of the final eligible population.

these participants were issued a pedometer and given access to walkingspree’s website, which includes community forums and other support. to meet the requirements, they needed to maintain an average of 5,000 steps per day in each three-month period. the pedometer, like other trackers, auto-uploaded user data so the data was not self-reported.

some people will take the lumps, some the sugar

when employers roll out these programs, employees have a choice. they can take the lump (the increased costs) or they can take the sugar (the financial incentive). with BCN, 17% opted out of the program and another 5% had a medical waiver and were legally excused from the penalty. a survey administered to those who completed the program found good results and mixed feelings:

• 97% of enrolled participants met the daily steps requirement
• 51% appreciated the program’s financial and health benefits
• 17% initially joined to save money but were ultimately satisfied with the program benefits
• 31% did not like the program and many noted feeling coerced to join

these are extremely positive figures. and if sustained over time, that’s real change. for those who have worried about the negative consequences of these results-based wellness programs, the authors recognize, “the program’s effect came at a cost of ill-will from some individuals who felt coerced to participate. while most of these members later appreciated the benefits of the program, nearly a third of them did not like the program, even in retrospect.” the authors seem to suggest that the disliking of the program came from the feelings of coercion, but it might also be that the feelings of coercion came from the disliking of the program. seventeen percent also joined to save money despite not really wanting to participate, but they were ultimately pleased with the program, too.

based on the available information, it doesn’t appear the study authors asked any questions before or after the program to see if there were any changes in feelings of loyalty or engagement. that’s too bad. more employers are rolling out these results-based programs that tie results to an incentive. this report gives them food for thought about planning for the possible ill-will. information on its possible impact on engagement and job satisfaction would also be valuable.

it’s important to note as well that one of the study authors is a scientific adviser to walkingspree and a an unpaid consultant to blue care network.

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p.s. the study contains insights on program design and communication worth the $39.95 download fee.

i’ve yet to talk with someone about employee wellness without hearing about how an employer allows—if not provides—donuts or cupcakes or something similar at meetings. the underlying message is the employer can’t be serious about wellness if they’re still offering such junk food regularly.

i don’t disagree. but how far is too far? the comments on a post about junk food-free workplaces suggests barring people from bringing in their own food is a bridge too far.

knowing this, i wonder how people will feel about the nonprofit physicians committee for responsible medicine’s (PCRM) decision to bar anything but vegan fare in its office. for those unfamiliar with a vegan diet, it shuns all animal products, including eggs and butter. today, 2% of americans consider themselves to be vegan, according to a gallup poll, with bill clinton the most famous among them.

a washington post article explains PCRM’s thinking:

“PCRM has an office policy mandating that only vegan food may be eaten in its office. The organization, which advocates for healthy eating, preventive medicine and ethical clinical research, is so committed to the rule that it notifies prospective employees of the policy when they receive an offer letter for a job.”

“PCRM decided to go vegan for a simple reason.

“‘We want to practice what we preach,’ said Susan Levin, the group’s director of nutrition education.”

in some ways, PCRM’s vegan policy is similar to tobacco-free workplace policies. PCRM dictates what happens on campus, but not off. in that respect they’re setting policies they feel best support their mission and goals. still, being vegan, even if only before 6, assumes an interest in being vegan and a willingness to do the work. a vegan diet is one of the more restrictive diets. the health benefits associated with it depend on eating mostly fruits and vegetables, whole grains, legumes, nuts, and seeds. and unlike with tobacco users, being non-vegan doesn’t impact the health of your co-workers.

PCRM is doing more than practicing what it preaches. according to the article, they’re helping others make the shift to a vegan diet, too, and studying the impact.

“PCRM has also piloted vegan eating programs at other workplaces in the Washington area. In one instance, they worked with a group of employees at Geico’s Chevy Chase headquarters. The nonprofit asked the insurance group to adopt a vegan diet and offered them weekly instruction on how to make healthy, tasty and cost-effective vegan choices. After 22 weeks, they compared employees in that group to Geico employees who hadn’t received the training. The vegan group lost more weight, reported improved physical health and said they saw a decrease in food costs.”

even with the pilots, it’s unlikely PCRM’s policy will be widely adopted. it seems unique to their culture and perhaps their population. ( at PCRM, one-third of employees already were vegans and another third were vegetarians.) so the policy question is where is the line when it comes to mandating what employees eat?

employers already have many ways to encourage our eating better. they can subsidize weight management programs, lower premiums for hitting certain biometrics, run nutrition and cooking classes. they can discount healthier food items in the cafeteria, bring farmers markets to work, use display tricks to drive up purchases of healthy items. they can even control what’s available in those cafeterias (and the vending machines).

for me, this means the line is drawn on requiring employees to adopt a specific diet, especially a diet practiced by so few and with so many requirements.

what about you? where is the line drawn?

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i’ve been writing on hotseat’s blog about the various ways companies are helping employees get more exercise and movement throughout the day. if you’re trying to figure this out for yourself or your employees, check out these posts:

• we don’t exercise enough. shocked?
• employers take different paths to get employees stepping
• office furniture that makes you work. out. 
• 7-minute, evidence-based workout

our may cohealth checkup was pre-recorded in las vegas during the human resource executive health & benefits leadership conference. carol and i gathered five thought leaders to discuss the themes bubbling up at the conference.

we were joined by andrew gold, VP, total rewards, pitney bowes, janet mcnichol, human resources director, american speech-language-hearing association, vlad gyster, CEO and founder, h.engage, bonnie pang, vice president, employee benefits, atlas insurance agency, and jennifer benz, founder and chief strategist, benz communications.

you can listen to the extended show here, on itunes, or via stitcher.

are you familiar with the cycle of aggravation? it goes something like this. you get irritated about something your spouse, parent, child, or someone does and you swallow your irritation. then you observe the irritant again, you can’t swallow your aggravation, and you blow. what the irritant is varies from person to person. it could be clothes dropped on the floor, toilet paper rolled the wrong way, toothpaste pressed from the middle—you name it.

difficult task + yelling = status quo

my husband and i have two irritants when it comes to our girls: their inactivity (irritation #1) and our uneven chore loads (irritation #2).

our girls are teens, and like other teens, they’re experiencing the steep decline in physical activity that comes at this age and continues right through adulthood for most of us. neither girl is into sports but both are into technology, so to resolve irritation #1 and make them more mindful of their activity, my husband and i gave them our nike fuelbands and suggested they start tracking their steps to see where they fall against the recommended 10,000 daily steps. if they hovered around 10,000 steps, we would relax. (this is code for i’d shut up.) if they didn’t, we’d hatch a plan. well, they routinely hit more than 7500 steps each day. irritation #1 resolved and mom forced to admit she was wrong. we still, however, had irritation #2 to deal with.

at this time, my husband and i alternated who was responsible for shopping and cooking and who was responsible for cleaning the dishes. the girls alternated who set the table and who cleared. the imbalance was OK when the girls were young. now, not so much.

difficult task + competition = behavior change

and here’s where it all comes together: the dishes, the daily steps, and the behavior change. i instituted a new family rule: he or she with the least amount of daily steps does the dishes.

day one: the youngest loses and she moans—loudly—about having to do the dishes.

day two: i’m quite motivated not to do dishes! so is everyone else, and alas, things do not go well for me. i lose and do the dishes. a collective sigh of relief is heard around the table.

day three: the girls start running in place while getting their dinner together to get a few extra steps before clocking in. not to be beat, i join them. the eldest loses, voices a slight grumble, and does the dishes.

day four and on: each night before dinner we compare steps and pronounce someone the dish fairy. there’s no moaning anymore about doing the dishes. the focus now is on getting more steps the next day.

essentially, i gamified doing dishes and getting more physical activity. i shifted the focus from the loathsome tasks to the competition, social comparison, and status, and i removed my husband and me as the heavies. we’re not cajoling the girls to do something they don’t want to do. they’re psyched to show off their steps and fiercely competitive about getting the most. they don’t mind throwing down a little smack talk, either.

this is how health games work at your office. sure they’re fun, as many have pointed out. but don’t be fooled. there’s more than fun happening here.

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in a recent post, i offered some thoughts on no-hire tobacco policies.

now marketplace’s pulled together a map to show which states have smoker protection laws. generally speaking, these laws prevent employers from implementing no-hire tobacco policies and from firing employees who use tobacco away from the worksite and during non-work hours.

the map’s content really isn’t that helpful. it gives you the year the state enacted the law and the statute number. you can find that on wikipedia. what is interesting, however, is to see how many states have passed a law offering such protection. today, the number’s 29, plus the district of columbia.

this is the map to watch.

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The Webby Awards cast their vote on excellence. Now it’s your turn.

We’re proud to be one of five candidates the Webby Awards selected in the Mobile & Apps: Games category. And since we’re judged by the company we keep, we’re delighted to have these games as our stiff competition: Cut the Rope, Spy vs Spy, Puzzle Craft and Draw a Stickman Epic.

Sitting down on the job won’t work here. Get up offa that thing and cast a vote for Hotseat. Voting closes on April 25, 2013.

this post was originally published on hotseat’s website. in case you were wondering why i was capitalizing things. 

as more employers consider how to reduce the percentage of tobacco users in their workforces, one policy in particular has raised eyebrows and hackles more than others: no-hire tobacco policies.

today, it’s mostly health care systems implementing these policies barring the hiring of tobacco users. they easily argue the importance of employing a workforce that boldly and uniformly stands for healthy lifestyle habits.

on the surface, it’s hard not to agree with the policy. and since health workers are the least healthy among us, perhaps we should consider this a laudable stand by their employers. but once you burrow into the ethical considerations, you may discover what a complex, divisive issue this is.

for example, should a health care system shun people with health risks or does doing so make a patient using tobacco feel less comfortable seeking its medical advice? do these policies recognize addiction and its messiness? most tobacco users endure multiple quit attempts before they’re successful—if they’re successful. if a health care system doesn’t support these attempts among its employees, what message does that send patients? and what of the social determinants of health that lead to a number of unhealthy lifestyle behaviors, including tobacco use? do these policies, in essence, isolate and discriminate against individuals born into the wrong zip code?

two articles currently appear on the new england journal of medicine’s website. one is the ethics of not hiring smokers. the other is conflicts and compromises in not hiring smokers. both tackle these questions at length and suggest any employer start elsewhere in its effort to curb tobacco use. the latter article raises an additional controversial question. it contends that the days when you can consider your behavior in isolation are soon to be behind us.

“Similarly, policies against hiring smokers shift the debate from the question of where one smokes to that of whether one smokes. Are these policies aimed at tobacco, which is harmful and destructive, or at people who are addicted to tobacco, who may be seen as victims? Do the policies target legally available products or people who make a personal choice that contributes to a social burden and could conceivably choose otherwise? Are the rules designed to reduce smoking, which is a population health goal, or to fence out smokers, which may be an institutional financial goal? How, exactly, should we look at these policies?

“We believe we should see them as one product of a growing recognition that changing behaviors is hard, that combating addiction is harder, and that behaviors that were once seen as exclusively private often have profound societal effects. As a result, many stakeholders are trying to change unhealthy behaviors through mechanisms as varied as legislative requirements for calorie labeling in some restaurants, bans on the sale of large servings of sugar-sweetened beverages, and Affordable Care Act provisions allowing employers to provide rewards or penalties worth up to 50% of employees’ health insurance premiums on the basis of health assessments, including smoking status. Those policies would have seemed like hard paternalism back when no one questioned passengers’ right to smoke on airplanes, but they might be seen as considerably softer now in light of social trends, and perhaps in the future we won’t consider them paternalistic at all.”

as we’re seeing with outcomes-based wellness, i suspect these authors are correct. ultimately, our view of what’s paternalistic will change. in the past, paternalistic meant providing jobs for life and pension plans. right now, paternalistic means “big brother” to many. tomorrow, paternalism will involve looking out for our social good, as these authors suggest. the trick as we shift toward this last definition of paternalism is keeping an eye on the balance between policies and programs that make health widely and almost innately practiced, and those that leave people to fend for themselves.

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more reading on free-range communication:

• mind if i sew a scarlet “t” on your chest? the communication and cultural challenges of no-hire tobacco policies
• why employers focus on tobacco cessation
• workplace smoking bans reduce heart attacks

on april 24 i’m moderating a panel on health games at the human resource executive health & benefits leadership conference in las vegas.

i’ve intentionally constructed a panel with varied perspectives, responsibilities, and backgrounds. my panelists include rajiv kumar, CEO of shapeup, inc.; chris cartter, general manager of meyou health; melissa yoakam, benefits manager for chipotle mexican grill; and cathy murphy, vice president of human resources operations and wellness for blue shield of california.

being a communication consultant, it’s in my DNA to gather audience input to help shape whatever i’m going to write or say. in that vein, i’m inviting you to crowdsource the questions i ask the panel. in exchange i’ll write a post to let you know what we bandied about.

to get you started, i’ve shared my panel’s initial list of questions. i’m sure we have more than we cover. so, while you’re adding your questions in the comments, please also call out which one of ours you’d really like answered.

thanks in advance,

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questions

1. let’s begin with a basic question: what essential design elements must be present to make a health game a game?

2. [to the game creators] because we associate games with fun, we often overlook the theory underpinning them. i want to take a look under the hood of your products. what behavior change and game design theory is baked into your game(s)?

3. do you see today’s games for health in the workplace having the same vitality and variety as games for health overall? how do they compare in these respects to games in general?

4. [to the game creators] one of the biggest plugs for health games is that they overcome the health engagement issues most employers see. so, what are you seeing with your game? who uses them most, and for how long?

5. [to the employers] have you seen a noticeable difference with games versus some of your other health promotion strategies? how did you define or quantify any difference?

6. [to the employers] you’re on this panel because you obviously believe in the potential of health games. but i’m sure you know there’s still some skepticism and curiosity about health games. what was your experience selling games internally? among your colleagues and industry peers, what have been the strongest objections and how have you responded to them?

7. of course employers aren’t the only ones who can be skeptical, curious, or perhaps uncomfortable with health games. employees too may find it challenging to use them within a work setting, or to share their private health goals. what have you experienced? what have you learned that can guide others’ successful implementations?

8. let’s discuss the juxtaposition of self-reported data and validated data. what’s the benefit derived from spending money on tools that deliver validated data? do all games deliver this? should they? are self-reported and anecdotal data actually sufficient to quantify and substantiate game ROI and benefits?

9. in 2012, shapeup and i collaborated on a survey to understand employers’ perceptions and current adoption of health technology, including games. one of the top implementation barriers cited by participants was cost. if i’m an employer and i have a limited budget, why a health game? why is this a good investment?

10. [to the employers] considering cost, how would you evaluate affordability? how would you look to evaluate ROI and show the value for the cost?

11. we know we’ll see many more companies adopt health games this year and in the coming years. how do we work together to leverage this gamification trend? what can we draw from it to construct meaningful experiences to increase engagement?