Without addressing root causes through sustained behavior modification, all results are temporary
The most effective approach to preventing and treating chronic disease today focuses on the creation of healthy habits that fundamentally change behavior in a sustainable way. Smart solutions involve personalized programs based on genetic testing, nutrition, exercise, mental well-being and 1:1 personal health coaching. This combination has achieved remarkable success in both warding off chronic disease before it arrives and slowing and reversing disease where it appears.
Perhaps the most critical component of any effective behavioral change/habit-building program is engagement. For programs to work, they have to not only evaluate and track change in key biometrics—such as blood pressure, blood glucose, waist circumference, depression and anxiety—they have to be designed so that participants enjoy the experience. This is an important issue: A recent study found that 38% of employees whose employers offered programs didn’t participate because they found them “generic” and “not motivational.”
Ongoing Engagement is Critical
Chronic diseases are far and away healthcare’s greatest problems today: 6 in 10 adults in the U.S. have a chronic disease, 4 in 10 have two or more, approximately 85% of adults are pre-chronic, and 86% of healthcare costs are attributable to chronic disease. This tremendous epidemic of chronic disease sweeping the nation didn’t happen overnight, and it can’t be solved overnight either. Damage done to our bodies, metabolism and mental health has accumulated over years or even decades. Healing requires focusing intent on changing habits and sticking with it.
Short-term dietary or exercise bursts of weeks -or months- sometimes can effect impressive and dramatic changes, but unless participants build a new way of life and a frame of mind committed to keeping that new lifestyle going, regression to old habits happens amazingly fast and in stunningly disheartening fashion.
One meta-analysis of 29 long-term weight loss studies, for instance, found that more than half of the weight participants lost was regained within two years—and by five years more than 80% of participants lost weight was regained. In other words, “long term benefits require long term attention.” A focus on incremental habit change tied to lasting engagement is the key to sustainable outcomes and cost savings.
So: How do you assess quality of engagement? Here are four important ways of measuring strong engagement:
– How many participants are reaching their goals? No matter how realistic and carefully planned goals are, they won’t be met without a commitment from participants.
– How often are participants reaching goals? Every success is a triumph, but if only one in four or even one in two participants is reaching their goals, something in the program needs to be tweaked to make it significantly more robust.
– Do participants stay engaged? This is an important factor to monitor both along the way to reaching initial goals—you don’t want anyone quitting halfway!—and afterward, too. Without this, relapse is inevitable.
– Do partipants readily recommend the program to others? When they do, this illustrates a serious and heartfelt belief in the program and its efficacy.
A strong program will generally be able to answer each of those questions with a measure that exceeds 75%. Today, corporations of all sizes are increasingly offering behavioral-based programs to their employees, and in the better programs, every engaged employee gets not only a set of customized nutritional, exercise and mental health prescriptions but a 1:1 dedicated behavioral coach, too. This has proven critical to maintaining engagement and accountability. This sort of behavioral coach isn’t an instructor, simply providing instruction or teaching a curriculum. Instead, coaches are part habit change designers, and part behavior change experts with training in nutrition, exercise, and cognitive behavioral therapy. These coaches serve as a confidant, accountability partner and resource to help employees establish new healthy habits for life.
The Fruits of Engagement
Strong behavioral-based programs show their value not only in engagement but also by helping companies decrease healthcare expenses. The results are real and dramatic, and that’s why programs of this kind are being used effectively today both by individuals and by employers including Levi Strauss & Co, Canon, and Aetna. A randomized controlled trial sponsored by Aetna evaluating a personalized behavioral change platform it used demonstrated meaningful clinical risk reductions and a $1,464 1st-year reduction in medical costs per participant on average which was endorsed by the Society of Actuaries.
Managers of tech-enabled habit-change platforms are working today with health insurers not only to prevent, reverse, and slow chronic disease, but also to lower the cost of healthcare, and ultimately to help insurers optimize the benefits they offer and the value-added services they provide. It’s an essential task: Ours is an aging population, and 80% of today’s older adults have at least one chronic disease condition and are at elevated risk for others.
Habit change is fundamental to creating sustainable outcomes, and the best behavioral change programs will always identify and focus on sustainable habit change as a core competency. MSK, hypertension, cancer, and mental health issues all flow from obesity and poor habits, and those poor habits must be addressed as the root of the issue.
Employers and health plans assessing future healthcare expenses today know they face steep cost pressures. A perfect storm of aging, a sedentary lifestyle, and—most recently—an exacerbating pandemic, spotlight clearly the growing challenges of managing chronic disease. What’s beginning to make a major difference in our world are programs that move the focus of healthcare to sustained habit change. These programs help employers contain costs. Better still, they help health insurers meet goals, stay engaged with sustainable healthier lifestyles, and ultimately lead healthier, happier, and more productive lives.
About Jeff Ruby
Jeff Ruby is the Founder and Chief Executive Officer of Newtopia, a personalized, whole health platform that helps people create positive lifelong habits to prevent, slow and reverse chronic disease.