Your SlideShare is downloading. ×
Steven Schwartz at Consumer Centric Health, Models for Change '11
Steven Schwartz at Consumer Centric Health, Models for Change '11
Steven Schwartz at Consumer Centric Health, Models for Change '11
Steven Schwartz at Consumer Centric Health, Models for Change '11
Steven Schwartz at Consumer Centric Health, Models for Change '11
Steven Schwartz at Consumer Centric Health, Models for Change '11
Steven Schwartz at Consumer Centric Health, Models for Change '11
Steven Schwartz at Consumer Centric Health, Models for Change '11
Steven Schwartz at Consumer Centric Health, Models for Change '11
Steven Schwartz at Consumer Centric Health, Models for Change '11
Steven Schwartz at Consumer Centric Health, Models for Change '11
Steven Schwartz at Consumer Centric Health, Models for Change '11
Steven Schwartz at Consumer Centric Health, Models for Change '11
Steven Schwartz at Consumer Centric Health, Models for Change '11
Steven Schwartz at Consumer Centric Health, Models for Change '11
Steven Schwartz at Consumer Centric Health, Models for Change '11
Steven Schwartz at Consumer Centric Health, Models for Change '11
Steven Schwartz at Consumer Centric Health, Models for Change '11
Steven Schwartz at Consumer Centric Health, Models for Change '11
Steven Schwartz at Consumer Centric Health, Models for Change '11
Steven Schwartz at Consumer Centric Health, Models for Change '11
Steven Schwartz at Consumer Centric Health, Models for Change '11
Steven Schwartz at Consumer Centric Health, Models for Change '11
Steven Schwartz at Consumer Centric Health, Models for Change '11
Steven Schwartz at Consumer Centric Health, Models for Change '11
Steven Schwartz at Consumer Centric Health, Models for Change '11
Steven Schwartz at Consumer Centric Health, Models for Change '11
Upcoming SlideShare
Loading in...5
×

Thanks for flagging this SlideShare!

Oops! An error has occurred.

×
Saving this for later? Get the SlideShare app to save on your phone or tablet. Read anywhere, anytime – even offline.
Text the download link to your phone
Standard text messaging rates apply

Steven Schwartz at Consumer Centric Health, Models for Change '11

581

Published on

Tackling the Double Helix: On the Road to Sustainable Behavior Change. …

Tackling the Double Helix: On the Road to Sustainable Behavior Change.
Sustainable health behavior change is possible.
To be successful, you must equally commit to health at the individual level and the social level.

Published in: Health & Medicine
0 Comments
1 Like
Statistics
Notes
  • Be the first to comment

No Downloads
Views
Total Views
581
On Slideshare
0
From Embeds
0
Number of Embeds
1
Actions
Shares
0
Downloads
0
Comments
0
Likes
1
Embeds 0
No embeds

Report content
Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
No notes for slide

Transcript

  • 1. Consumer-Centric Health Models for Change ‘11
  • 2. Tackling the DoubleHelix: On the Road to SustainableBehavior Change Social Context Individual ContextSteven M. Schwartz, PhDDirector of Outcomes Research & Data AnalyticsWellness & Prevention Johnson & Johnson
  • 3. Is Sustained Population Change Possible? Yes!
  • 4. Components of HealthPass Annual invitations Confidential Health Risk Assessment – Succeed! (web or paper) Biometric screening – Total Cholesterol, HDL, Glucose – Blood Pressure – Height, Weight, Body Fat, BMI Individualized or group counseling Digital Health Coaching Referrals to healthcare resources and interventions Communication with the member’s provider for continuity of care Educational information Assist members in finding a Primary Care Physician
  • 5. Figure: Return On Investment of HealthPass® by Year 4.00 Positive ROI 3.00 2.83 1.98 1.93 2.00 1.56 1.58 1.56 1.30 1.16 ROI=1:1 1.00 2002 2003 2004 2005 2006 2007 2008 2009 Negative ROI 0.00 -1.00 -2.00 Average ROI = 1:1.74For every 1 million invested in HealthPass®, 1.74 million saved on Healthcare expenditures
  • 6. Figure 3: 2009 Total Member HealthCare Costs by Number of YearsUsing the HealthPass® Program among Members with 2009 Costs > $0 Note: Health care costs include inpatient, outpatient, medical, and pharmacy costs. Data were derived from members with 2009 total health care costs >0. Members who had conflicting sex in multiple data sets, who reported pregnant or more than 365 total inpatient days in any one year were excluded. Savings were adjusted for sex, age, morbidity in 2002, and total health care cost in 2002. The 2009 health care costs were significantly different by number of participation year, F(8, 159993)=11.52, P<.0001. Key Message: There is a dose-response-like relationship of program participation to total expenditures. The more years participated in the HealthPass®, the lower the average costs.
  • 7. But What About Behavior Change & Risk Modification?
  • 8. Figure 4: Changes in Total Cholesterol by 2002 Cholesterol Status among HealthPass® Users Since 2002 100% 100.0% Total Cholesterol ≥ 240 (%) 80% 60% 40% 34.2% 25.3% 26.1% 27.8% 22.9% 24.3% 16.9% 20% 5.3% 4.8% 6.7% 4.4% 5.3% 3.6% 3.8% 0.0% 0% 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 Year in HealthPass Total Cholesterol in 2002 < 240 Total Cholesterol in 2002 ≥ 240 Note: NHLBI Guideline: Total Cholesterol <240 mg/dL; 86% of yearly HealthPass participants in 2002 met the guideline. Total cholesterol in 2002 under 240 mg/dL: N = 13,381; total cholesterol in 2002 240 mg/dL or above: N = 2,182.
  • 9. Figure 6: Changes in High Stress* by 2002 Stress Status among HealthPass® Users Since 2002 100% 100.0% 90% 80% 75.7% 70% High Stress* (%) 62.8% 60% 50% 39.9% 37.7% 40% 35.5% 33.3% 32.8% 30% 22.1% 20.7% 20% 13.7% 13.3% 13.2% 12.5% 9.9% 10% 0.0% 0% 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 Year in HealthPass Low stress in 2002 High stress in 2002 Note: High stress cut-off < 8/10 in Succeed HRA Behavior Score; 41.8% of yearly HealthPass participants in 2002 fell within the recommended guideline. High stress in 2002, N = 9,080; low stress in 2002, N = 6,517.
  • 10. Figure 5: Changes in Body Mass Index (BMI) by 2002 BMI Status among HealthPass® Users Since 2002 100% 100.0% 86.7% 90% 83.2% 82.8% 83.5% 82.6% 79.2% 78.0% 80% 70% BMI ≥ 30 (%) 60% 50% 40% 30% 20% 10% 2.8% 2.4% 3.0% 3.3% 3.8% 3.9% 0.0% 1.8% 0% 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 Year in HealthPass BMI < 30 in 2002 BMI ≥ 30 in 2002 Note: Obese and extremely obese cutoff: BMI ≥30; 85.7% of yearly HealthPass participants in 2002 fell within the recommended guideline. BMI < 30 in 2002, N = 13,362; BMI ≥ 30 in 2002, N = 2,225.
  • 11. The Key Ingredients: A Dual Perspective Social Perspective • Culture of Health • Organizational approach To be successful, you Participation & Engagement must equally commit to health at the individual level Individual and the social Perspective • Activation Segmentation level. • Behavioral Science • Meaningful Incentives11
  • 12. Wellness & Prevention, Inc. National Landmark Study Attitudes and Behaviors Regarding Health• Comprehensive and proprietary study – Current motivations / priorities, behaviors, and barriers to improving health – Their starting point, their language, their struggles and needs• Two Phases Conducted – Phase One: Qualitative Needs Assessment Exploration • 4 InQuest Focus Groups in 2 US Cities • 18 One to One interviews in 2 US Cities • Completion of extensive homework journal. – Phase Two: Quantitative Online Assessment of Needs, Attitudes, and Behaviors • Sample of 3,007 full-time employed U.S. adults • 60 minute questionnaire covering a broad array of topics12
  • 13. In my company, programs are… 6 6% Integral part of company mission/culture 5 20% Strongly promoted/supported 4 32% Offered, somewhat promoted 3 15% Offered, but not promoted/supported 2 14% Talked about, but not put into practice 1 14% Not visible/evident Wellness & Prevention, Inc. Landmark Study, 200913
  • 14. The Culture of Health and Confidence/Motivation Level of Motivation & Confidence 1 1 2 2 3 3 44 5 5 6 6 Strength of Culture of HealthWellness & Prevention, Inc. Landmark Study, 200914
  • 15. Establishing a Culture of Health is Critical Positive Impact – If Authentically, Consistently Supported Individuals’ Feelings if Company Were to Provide Population Health Programs Skeptical Grateful/Loyal Wellness & Prevention, Inc. Landmark Study, 2009 * % of Respondents, indexed to % among total sample15
  • 16. An Individual Perspective:Evaluating Values and Activation Segmentation 16
  • 17. 0.5%Which value, trait, or characteristic best 3.2%completes the following sentence: 23.3% 0"Being _________ is important to me." 1Please choose up to three. 72.9% 2 3• Successful 22%• In control 22%• Responsible 34%• Disciplined 11%• Strong in character 21%• Energetic 22%• Independent 28%• A good parent 36%• A good grandparent 11%• A good spouse/partner 38%• A good community member 4% 0.0% 10.0% 20.0% 30.0% 40.0% 50.0%
  • 18. 48.6% Parent Spouse 28.7% Responsible Spouse 26.8% Responsible Independent 26.5% Responsible Parent 23.9% Control Independent 21.6% Energetic Independent 20.5% Control Energetic 20.1% Successful ControlStrong links are heavier
  • 19. Does Value Increase Motivation & Confidence?- Baseline 10 8.0 Disciplined 9 Successful 7.9 Baseline Confidence to Manage Health 8Baseline Confidence to Manage Health Have value Strong in Responsible 7.8 character 7 Spouse No value Parent 6 7.7 Community Energetic 5 Grandparent 7.6 4 7.5 In control 3 Independent 2 7.4 1 7.3 0 7.2 0 1 2 3 4 5 6 7 8 9 10 8.2 8.3 8.4 8.5 8.6 8.7 8.8 8.9 9.0 Baseline Motivation to Manage Health Baseline Motivation to Manage Health High motivation is associate with high confidence.
  • 20. THE SIX “ACTIVATION” EMPLOYEE SEGMENTS I’m already stretched Help! It’s scary to think about Sharing the journey really keeps how much I need to do taking care of work and family. everyone’s momentum up. We learn For me to focus on my own well-being, and whether I can even do it.from, help and encourage each other, it has to be a company goal Frankly, I don’t even know and we have fun along the way. that I have team accountability for. what the first step should be. Permission-Seeking Booster Clubbers Insecure Rookies Team Players I’m already on the fitness bandwagon. What and when I do is up to me There are much bigger issues It’d be great if my company and it will be on my own terms. to be dealt with provided me some resources, It’s not something I want my employer / before I can even think about but my challenge is simply consistency. coworkers concerning themselves with. health & wellness. Energized Free Agents Forced Forfeiters Champions
  • 21. Well-Being: Overall, Physical, Mental, and Emotional 70 60 50 40 30 20 10 0 Booster Perm Seekers Insecure Energized Free Agents Forced Clubbers Forfeiters Overall Physical Mental Emotional The pattern of well-being is the same across segments. Physical well-being is always the lowest regardless of segment. Insecure are the worst off and that is true for all aspects of well-being.
  • 22. Energy Levels Through the Day. 70 60 50 40 30 20 10 0 Before Beginning Middle End After Weekend Booster Clubbers Perm Seekers Insecure Energized Free Agents Forced ForfeitersThe pattern of energy levels is similar across segments.Insecure have the lowest energy throughout the day.Perm Seekers have an unusual burst when they get home.
  • 23. Motivation and Expected Difficulty 80 70 High Motivation Segments 60 50 Low Motivation Segments 40 30 20 10 0 Booster Perm Seekers Insecure Energized Free Agents Forced Clubbers Forfeiters motivation difficulty Segments fall into high and low motivation groups. Insecure rates expected difficulty higher than the others.
  • 24. Social Connection Attitudes8070605040302010 0 Booster Clubbers Perm Seekers Insecure Energized Free Agents Forced Forfeiters I will make it a higher priority if I know someone else is counting on me Sets me up with a partner -- and we do it together Relieved when I find a buddy / partner to do it with me Provided by someone who has been where I am, but has been successful in making real progress Consistent Pattern across segments. Booster and Perm Seekers are the most social. Having others depend on you is more motivating than having help from others.
  • 25. Segmentation Demands Flexibility Booster Permission- Insecure Energized Forced Free Agents Clubbers Seeking Team Rookies Champions Forfeiters Players D Facilitator of Core Permission The Role Connections (Private) Provision Tools Teacher… Granter… You Play …”Social Tutor/Teacher (Healthy Supplier Enlighten Absolver Chairman” foods, gym)25
  • 26. Key Point… • Individuals have different needs, wants, and desires and are on different points in their journey! One Approach will not reach the majority of individuals. A variety of approaches are required to meet everyone’s needs!26
  • 27. Conclusions• We must address the double helix – interventions at the societal and individual levels• Changing behavior on a large scale is an imperative to success• We cannot rely on Cultural change to come from the traditional medical establishment or government• Effective solutions will combine deep understanding of human nature and leverage technological innovation to reach them in situ

×