Bridging Intention and Action for Employee Well-Being Using the Intentional Action (InAct) Process: Workshop-Lecture Series

Abstract

Background

Employee wellness programs can help manage stress and alleviate burnout.

Objective

To pilot and disseminate the Intentional Action(InAct) concept for employee wellbeing.

Methods

Five independent interactive workshop-lectures with an automated audience response system. Descriptive analysis of participant response data.

Results

Participants (n = 275): rated spirituality, physical environment and nutrition the most highly in contributing to their present well-being. Ninety-eight percent (n = 269) of participants identified a focus area to work on. The well-being area most selected was Exercise, (35% n = 95), however, other non-traditional areas, including Personal and Professional Development (18% n = 48), Relationships and Communication (17% n = 47), were selected, along with mind-body connection and mindful awareness (6% n = 15 and n = 16).

Conclusion

The pilot engaged employees to reflect and set goals for their future well-being. Healthcare institutions implementing programs should consider a broad range of whole person strategies addressing employee well-being, which go beyond the traditional focus on exercise and nutrition.

Introduction

Healthcare employee wellness is largely shaped by work-life harmony, positive peer-support, and professional growth environments. ¹ The absence of these experiences is likely to lead to employee burnout, potentially impacting personal well-being, social relationships, and even the quality of healthcare delivery. ¹ Many healthcare institutions generally provide “one-size-fits-all” strategies to address institutional burnout and improve employees’ well-being. Due to limited evidence or short-term benefits from existing strategies, ² there is a need to create sustainable and meaningful personalized strategies that assess and address multifaceted work-life challenges to improve employees’ well-being. ³ As healthcare professionals (HCPs) are at high risk for burnout, it is critical to develop efficient and effective strategies to better manage stress, set priorities and feasible goals, and follow through with sustainable personalized changes. ⁴

Health and Wellness Coaching (HWC) is a growing field within employee wellness programs (EWPs) that uses person-centric behavioral strategies including motivational-interviewing, reflective and empathetic listening, mindfulness, resiliency training, emotional intelligence, problem-solving, and goal-setting strategies to adopt and enact sustainable behaviors and actions, and to foster accountability. ⁵ There is a substantially growing evidence base of varying value and impact integrating HWC in EWP, on improving different aspects of employees’ well-being, reducing stress and burnout, and increasing joy, engagement, and even healthcare savings. ⁵ However, there is limited evidence of using scalable and user-friendly HWC-based interventions to improve HCPs wellbeing on a broader scale.

We hypothesize that the Intentional Action (InAct) framework—provided through a HWC-based interactive workshop-lecture—provides outreach while creating personalized experiences, allowing participants to focus on a multitude of contextual possibilities that stimulate insight into their personal and professional well-being, intention to target priority areas, and future action plans.

Methods

Setting

Interactive workshop-lectures were convened at five healthcare sites within two separate academic institutions across Florida and Arizona as part of institutional efforts to improve employee wellness. Workshop-lectures were single, 60-minute sessions delivered on 5 separate occasions at each of the 5 participating sites. Attending HCPs/participants were informed and briefed about the nature and intent of these interactive workshop-lectures. Consenting was voluntary and non-participation was not a reason to exclude attendance. All activities were deemed exempt by the respective Institutional Review Board.

InAct Lecture-Workshop Structure

InAct is a semi-guided user-friendly and person-centric HWC-based approach. It involves the steps of 1) Reflecting on one’s present overall wellness areas and values to determine an area of focus they would like to improve; 2) Setting a goal(s) related to achieving the health and life that one wants. Goal(s) setting is guided by SMART ⁶ criteria (Specific, Measurable, Attainable, Relavent, Time-Based); 3) Using mindfulness to stay aware of that present goal(s) and intention without judgement; 4) Exploring potential pathways to attaining the knowledge needed to move forward with that goal(s); and 5) Creating action plans for the designated goal(s). The InAct framework is illustrated as part of Figure 1.

Figure 1.

The Process of Intentional Action (InAct) and Summary Pilot Results.

The Duke Wheel of Health (https://dukeintegrativemedicine.org/patient-care/wheel-of-health) helped to explain the prospective areas of wellness and healthy practices presented and surveyed. The semi-guided survey questions–using1-10 Likert scale—were conducted through real-time anonymous/deidentified Audience Response System. Once completed, an introductory and evidence synopsis about Mindfulness practices was shared with the audience, with an opportunity to participate in a brief guided mindfulness practice. At the end, a conclusive summary of the InAct framework and Mindfulness educational resources were shared with the audience.

Data Analysis

Anonymously-polled deidentified data were collected and aggregated in Excel and analyzed securely and privately by members of the study team only.

Results

Data included 275 participants-HCPs from the five distinct locations. The InAct steps and audience responses are summarized within Figure 1.

Discussion

The InAct interactive lecture-workshops series engaged employees to voluntarily participate and reflect on a broad range of well-being focus areas, prioritize and rate these areas of well-being, and mindfully assess their willingness to explore self-identified well-being goals, and to create an action plan to work towards these goals. Participants were able to reflect on a multitude of areas, including areas not traditionally or commonly highlighted in EWPs. While some well-being focus areas that are traditionally included in well-being employee initiatives were rated high by participants (Movement, Exercise, Rest), other traditional areas rated lower (nutrition and the physical environment) with other non-traditional areas rated as higher focus and priority (Relationships and Communication).

There is a need to explore, contextualize, and prioritize health promotion strategies in the workplace based on a variety of individualized factors along with institutional-focused strategies. ² While employees may be provided traditional choices or they may rank certain well-being areas as important areas for improvement, they may prioritize different or attainable areas to start. ⁷ Even though healthcare workers may be more knowledgeable about and have better access to physical and nutritional health resources, healthcare institutions tend not to place as much emphasis on other aspects impacting overall well-being, such as spiritual growth and interpersonal and social relations. Many participants in this study placed importance on social connections, bringing meaning to life through spirituality and mindfulness, which is consistent with findings from previous work in various settings. ⁸ Ignoring broader priorities and aspects of well-being by implementing a one-size-fits-all approach may fail to adequately improve well-being by putting undue focus on certain aspects of well-being that might not be the ones most needed or wanted.

HCPs should be supported in their individual choices. Engaging staff when designing and implementing interventions has resulted in improved feasibility, usability, and outcomes of these programs. ⁹ HWC offers this potential with its person-centric and multidimensional use of motivational and mindful strategies to foster positive, sustainable changes and accountability. Guiding employees using the HWC-based interventions can help individuals to broaden their options; reflect on their personal values; prioritize and select which goals feel right for them at this time; provide the knowledge and education necessary to support their choices; and stay focused on and take the necessary actions to set their goals in motion and stay focused on their goals through intentional mindfulness. If further needed, ongoing individualized HWC may be pursued to support employees to re-evaluate their needs, values, and goals over time and within the context of their lives. ⁵

The InAct framework is designed from the outset in a scalable, user-friendly format to support individuals as they reflect, prioritize, set goals, and take action to improve their personal well-being. InAct offers a translatable way of disseminating broader employee well-being and could be a continuous, annual offering within institutional employee wellbeing programs, providing sustainable and meaningful feedback about potential barriers and opportunities to employers. Interventions integrating HWC elements (mindfulness, emotional intelligence) have shown varied success.^3,10 This could be explained by studies’ brevity or insufficient assessment of employees’ relevant needs and goals; long-term, and person-centric research is needed.

Conclusions

For healthcare institutions, when implementing employee wellbeing programs, it is important to take a whole-person approach in identifying and supporting what most matters to employees and allowing employees to prioritize areas of focus in order to enable them to live their well-being vision. This may include aspects such as personal health, social connections, spiritual beliefs, and professional career goals that are not traditionally accounted for or prioritized in EWP. The HWC-based InAct framework provides a simple strategy to help HCPs identify, prioritize, and act on person-centric well-being goals while highlighting relevant feedback to their respective institutions and EWPs.