The mission we re trying to accomplish Creating a healthier world by leveraging social influence to engage people in healthy activities We learn every day from amazing clients Perfecting our behavior change model Social Marketing Campaign Coaching Financial Incentives Enrollment & Activation with Social Tools Self Assessment & Realistic Goal Setting Healthy Games & Challenges Progress Tracking & Milestones 1 2 3 4 5 Improved Health & Social Rewards Readiness to Change Biometric Devices
Unhealthy behaviors are contagious But healthy behaviors are social too! Harnessing social influence for health 1 Create connections 2 Competitions & challenges 3 Peer-to-peer invitations 4 Facilitate conversations 5 Public expression 6 Peer encouragement 7 Status & comparison 8 Rewards for social behavior Social platforms help spread the health Letting employees support each other Social Games Social Stats Social Newsfeed Find Friends
Let employees form groups and teams Leveraging peer accountability Team List Team Conversation Share small, positive actions with friends Health forums, user groups, expert Q&A Why is social transformative? Program Type Avg. Engagement + Incentives Coaching Programs 6% 22% Weight Management 8% 8.5% Walking Program 10% 20% Biometric Screening 22% 42% Social Wellness 30%+ 50%+ Source: 15th Annual National Business Group on Health/Towers Watson Employer Survey on Purchasing Value in Health Care. (coaching, weight, and biometric data). Analysis based on an average company size of 7,500 employees with an average workforce age of 43 years, 55% male population and average industry distribution with no financial incentives offered. Walking program and ShapeUp data based on book of business client experience.
Games are changing the way we live Games satisfy core human desires Reward Status Achievement Expression Competition Altruism Points Levels Challenges Virtual Prizes Leaderboards Gifts/Charity Competitions are a powerful social game Activity and nutrition team challenges 60% of U.S. employers offer a health competition, with an additional 27% planning to offer them in the next three years. 1 2 3 Ready Set Go Step It Up Face Off Working Well: A Global Survey of Health Promotion and Workplace Wellness Strategies. Buck Consultants. Balancing Act Fit & Festive Flex Your Food Fight The Flu Crowdsourcing peer-to-peer games Games give people a reason to track Tracking Calendar Personal Stats Trend lines
Games facilitate comparison of results Why is gaming transformative? 40% 35% 30% 25% 20% 15% 10% 5% 0% 1.2% +8.5% 7.3% Healthy BMI Overweight BMI Obese BMI Start End Wing, R et al: A Statewide Intervention Reduces BMI in Adults: Shape Up Rhode Island Results. Obesity 2009 SMS still plays an important role But smartphones are proliferating Apps for physical activity measurement
Apps for calorie tracking and sharing Apps for healthy food logging + sharing Apps for sleep quality tracking Workplace apps for promoting exercise Why are mobile apps transformative? It is always a challenge for us to reach everybody. We have a diverse workforce with many field sites or manufacturing sites. That s why on-site connection is important. 70% of our employees have access to internet on a regular basis. For the 30% who don t have work access we think they have access at home or at least a kiosk or lab. We have a vast majority of employees that don t have a computer but do need to lose weight. They tried to manage reporting by phone but it was not effective for them.
Low-tech devices do change behavior Outcomes-based rewards gaining steam Employers Using Rewards or Penalties Based on Health Outcomes 100% 80 60 No 40 20 0 Yes 2011 2012E Connected devices provide validation GreenGoose activity monitor card Jawbone UP wristband Withings blood pressure monitor
Fitbit Aria wireless weight scale Basis heart monitor wristwatch Consumer sites have done this for years Employee platforms are now doing it too Activity automatically synced on website Ways to use them in wellness programs Employees with a device can link it for easy tracking Employees can purchase a device directly from the manufacturer Purchase devices for some or all of your employees employees Devices can be offered as an incentive for results in the program
Why wireless devices are transformative We can t look at health in isolation. It s not just in the doctor s office. It s got to be where we live, we work, we play, we pray. U.S. Surgeon General Regina Benjamin LA Times, March 13, 2011 Wellness programs are going global 24/7 multi-lingual phone + email support Interpreter Employee Calls with Question in Spanish Employee Interpreter Answer Delivered ShapeUp Rep Interpretation of Question and Context Knowledge Transfer Easy, rapid, multi-lingual translations Why global programs are transformative Platforms are becoming available in many languages New languages can be added easily All new platform text automatically exported, rapidly translated, and imported via an API US English Latin-American Spanish EU French Korean UK English EU Spanish Italian Simplified Chinese CA French German Japanese Traditional Chinese The big question we ve been asking with our wellness program is how do we make it truly global. We have a tough time because of the diversification of multiple cultures. Different cultures are harder to engage. We have to think about the geographic nature of employees; what is culturally acceptable and what is unique and relevant for this country.
Three innovative ways to do incentives Reward Progress Reward in Real Time Reward Social Actions Rewarding employees for progress Rewarding employees in real-time Rewards for measurable improvements Puts the focus on the journey and not just the destination Gives all employees a fair chance Don t make employees wait Smaller amounts now carry more weight than larger amounts later Increase the impact of your incentives without increasing your budget IBM patents real-time food rewards Rewarding employees for social actions Providing Consumers With Incentives For Healthy Eating Habits Encourage peer-to-peer recruitment to maximize participation Promote peer support to facilitate group behavior change Leverage accountability to keep people honest and engaged
Why will this be transformative? 100% 80 n=22 No n=16 Results n=13 $1,000+ $500-$700 n=12 HSA contribution 60 40 Yes Participation $300-$500 $100-$200 Prizes Discount on premiums Average Incentive Amount = $375 20 $1-$100 Cash 0 Offer incentives Basis of incentive Average amount (per yr) Format of incentive Average amount 375 Traditional telephonic coaching is broken Online coaching solves key problems Can be effective, but very low utilization We ve seen a savings of $869 per person per year for the 530 people who have been enrolled for 2 years. Telephonic coaching is difficult, although for people who are struggling with a certain issue, this type of support can lead them to the next level. Some are unclear if it is useful How effective is coaching itself? Given the small number of participants, we pay a lot for it. Others are sure that it is not We pulled the plug on telephonic health coaching only a small percent respond. It s not a very motivating model. Asynchronous messaging is convenient Peer coaching offers great promise Peer coaching appears to have merit as a viable, low-cost intervention with the potential of helping individuals with diabetes who need to change their behavior. The addition of online coaching from a peer significantly increased engagement and retention in the program. 1. Peer Coaching: An Intervention for Individuals Struggling With Diabetes, Joseph, D. The Diabetes Educator. Sep/Oct 2001 2. An Online Recovery Plan Program: Can Peer Coaching Increase Participation? Simon, G. Psychiatric Services, Vol 62 No 6, June 2011.
Why online coaching is transformative Actual Data from a 40,000 Employee Company Telephonic Coaching # Engaged 300 Online Coaching # Engaged 1,871 This approach drove a 524% increase in coaching engagement Using networks to target employees Connections Degrees Centrality Convincing What does your network really look like? Exploration Avery Senior Vice President Hussan Mares Hopper Drilling McWatters Milavec Production Milavec Waring Dhillon Crossley Ramirez Hussan Hopper Smith Dhillon Keller Angelo Smith Klimchuck Mitchell Crossley Schultz Myers Zaheer Keller Angelo Sutherland Mitchell Cordoza Schultz Cordoza Waring Myers Mares Avery McWatters Zaheer Sutherland Klimchuck Ramirez Target interventions based on the data Why network analysis is transformative Kevin Bacons : central individuals with a short path to anyone else Steve McQueens = peripheral non participants