Health Self-Management Applications in the Work Environment: The Effects on Employee Autonomy

Abstract

Organizations increasingly use Health Self-Management Applications (HSMAs) that provide feedback information on health-related behaviors to their employees so that they can self-regulate a healthy lifestyle. Building upon Self-Determination Theory, this paper empirically investigates the basic assumption of HSMAs that their self-management feature provides employees with autonomy to self-regulate their health-related behavior. The two-phase experimental study contained a 4-weeks HSMA intervention in a healthcare work environment with a feedback factor (performance vs. developmental) and pretest and posttest measurements of participants' perceived autonomy. Following the experiment, interviews were conducted with users to gain an in-depth understanding of the moderating roles of feedback and BMI (a proxy for health) in the effects of HSMA on perceived autonomy. Findings reveal that the use of an HSMA does not significantly increase perceived autonomy, and may even reduce it under certain conditions. Providing additional developmental feedback generated more positive results than performance feedback alone. Employees with higher BMI perceived a greater loss of autonomy than employees with lower BMI. The reason for this is that higher-BMI employees felt external norms and standards for healthy behavior as more salient and experienced more negative emotions when those norms are not met, thereby making them more aware of their limitations in the pursuit of health goals.

Ethics in Design and Implementation of Technologies for Workplace Health Promotion: A Call for Discussion

“…The underlying assumption was that the use of digital health technologies provides workers with autonomy via feedback and the freedom to respond to self-regulate health-related behaviour. Despite adjustments to the messages, intended to limit the impact on worker autonomy, these findings revealed that the use of a sensor technology did not significantly increase perceived autonomy and may have even reduced autonomy under certain conditions, especially for less healthy workers ( 50 ). Moreover, the workers who had used an activity tracker to monitor their behaviour before they received an employer-provided device experienced the same decrease in autonomy as the workers who used the activity tracker for the first time.…”

“…The project SPRINT@Work is an EU-funded interdisciplinary project aimed at developing and evaluating sensor and intervention technologies that contribute to keeping ageing workers healthy and effectively employable (45,(50)(51)(52)(53)(54)(55)(56). These health-related technologies were developed and implemented by researchers and engineers from a variety of disciplines (cognitive neuroscience, information management, biomedical engineering and rehabilitation medicine, community and occupational medicine), in collaboration with companies.…”

“…The second case study was about a research on health self-management applications in the workplace of health care workers. This study aimed at investigating whether use of sensor and intervention technology enhances the autonomy of workers in self-regulating their health-related behaviour ( 50 ).…”

“…Worker autonomy as a prerequisite for health self-regulation was empirically investigated in the study of Bonvanie et al ( 50 ). It examined activity trackers that give feedback information on health-related behaviour to workers.…”

“…And where do they overlap? Interestingly, the participants in the study of Bonvanie et al ( 50 ) stated that the ability to maintain their health is, partially, the responsibility of the employer, because their work environment has a large impact on this ability, and that their employer took this responsibility quite seriously. Both the employer and the workers experienced the intertwined nature of health, work, and the home environment, and aim to improve the collaboration on improving the overall health of the worker (see process Figure 1 : individual level worker-employer).…”