August 24th, 2015
By Karin Bultman, Vice President of Market Development, RedBrick Health
In April 2015, we commissioned a survey to explore how buying patterns, program offerings and program design have adapted given the rapidly changing healthcare environment. This survey was a follow-up to a similar survey we sponsored in 2010. Our goal was to better understand benefits strategies around wellness and health management and how they relate to healthcare costs.
One of the things we were curious about was how employers are defining engagement. As wellness programs mature, is the definition of engagement evolving as well? Are employers looking for more than mere participation? And if the definition of engagement is evolving, how will this impact programs for employee health and well-being?
As it turns out, we did see the beginnings of a shift. While employers largely still define engagement in terms of participation, there is an increasing awareness of the importance of an attitudinal awareness of healthy living—and how this impacts employee health.
As part of our survey we asked respondents to characterize their organization’s definition of engagement in an open-ended response. They conveyed definitions of engagement that include employees:
Given what we saw in the survey, and our experience in the day-to-day of employee health and well-being, we think it reasonable that over the next few years, the definition of engagement will continue to shift toward one that encompasses behavior change and improvement in health status. This continuing shift has ramifications for:
Yes, the definition of engagement seems to be maturing—and with this maturing will come the need to take a new look at the programs and options available to not only get employees on the path to wellness, but get them to a destination.
How does your organization define engagement? And is that definition changing?
See more survey results in our upcoming white paper, Employee Health Management Comes of Age, on RedBrickHealth.com.
August 11th, 2015
By Eric Zimmerman, Chief Marketing Officer, RedBrick Health
This post was adapted from an article originally published by the Institute for HealthCare Consumerism (IHC).
I first cut my teeth as a wellness program coordinator during my internship at the Mattel toy company. It was truly the dark ages of technology. No Web. No smartphones. No social media. We scanned HRA questionnaires through optical readers and gave out printed reports. We delivered classroom educational programs and one-on-one counseling. We staged worksite challenges and tallied team data by hand into leaderboards.
Indeed, we lacked the high-tech tools that make up the modern wellness arsenal.
Fast forward to today. So much has changed. But let’s start with what’s stayed the same. Behaviors—inactivity, poor nutrition, inadequate coping skills, spotty treatment adherence, use of tobacco and other substances. What’s more, there’s greater financial responsibility in the face of an increasingly complex and still weakly coordinated healthcare system, driving the need for greater “healthcare consumerism.”
So is technology transforming the delivery of worksite wellness? Clearly it is. But not just because it lets us reach people faster and cheaper, or create cool stuff. It’s because we can put into practice powerful principles of behavior change in a more scalable and effective way—and make it more fun at the same time.
Here are seven key principles we use to guide the consumer experience, and how technology powers them.
Is it technology that’s making the difference? Yes, in that it’s powering smarter design based on a more informed view of how behavior works. Does it work? We’re seeing the rapid growth of a rich data set that suggests it does. And we’re just at the beginning.
Part 2 of a 2-part series
By Sanna Yoder, Senior Director, Content Strategy and Behavior Design, RedBrick Health
In part 1 of our series, we introduced mindfulness as a practical solution to address the stresses of everyday life and discussed a few mindfulness practices. In this post, we’ll introduce a few additional mindfulness techniques, including one from Amit Sood, chair of Mayo Clinic’s Mind-Body Medicine Initiative.
Sood integrates elements from neurosciences, psychology, philosophy and spirituality to offer a scientific approach for stress management. His “Guide to Stress-Free Living1“ offers countless simple but profound exercises to reframe the stresses of daily life at work. He recommends a simple practice of joyful attention at least four to six times a day.
Here’s how it works: While your computer starts up, close your eyes and send an imaginary thank-you email to someone who’s helped you. While the traffic light is red, note of the shape and color of the cars around you. For just a few seconds, relax all your “frowning” muscles. Refocusing the mind, says Sood, helps cultivate flexibility of attention, allowing you to switch between a narrow focus and broad, relaxed attention at will.
At RedBrick, our coaches and our RedBrick Journeys® digital coaching program promote a practical approach to mindfulness that you and your employees can try right now with ideas like these:
Which one appeals to you most? Have you taken a “time out” today? If not, take one of these to your work group right now. Give them the immediate gift of a few moments of mindfulness—and over time, use these techniques to boost their resiliency.
1Sood, Amit, M.D., M.Sc. “The Mayo Clinic Guide to Stress-free Living.” Da Capo Press: Boston, MA. 2013.
Part 1 of a 2-part series
By Sanna Yoder, Senior Director, Content Strategy and Behavior Design, RedBrick Health
No matter what the make-up of your population, there’s a cost-effective prescription for better health—one that may help lower blood pressure, reduce the effects of depression and anxiety and improve sleep. It may even help control cravings.1
It is called mindfulness, and it’s a practical solution to address the stresses of everyday life.
Mindfulness costs nothing but a few moments of time. It can be practiced anywhere. And while it can help employees feel better in the moment, it may even have a long-term impact, improving job performance, reducing turnover intention2 and increasing the resiliency of your work group.
But how do you “get mindful?” Or promote the practice in your work group? Do you have to carve out 20 minutes to sit and meditate? Do you need special training? Do you have to leave your desk or listen to a soothing voice? Do you have to close your eyes?
These are all valid aspects of being mindful, but sometimes, in the hectic pace of today’s workplace, they’re impossible. That’s why many mindfulness experts promote what author and scholar Karen Kissel Wegela calls informal mindfulness practices,3 or everyday activities that can support an attitude of mindfulness. Here are a few of her suggestions:
Rick Hanson, psychologist, best-selling author and senior fellow at UC Berkeley’s Greater Good Science Center, encourages a practice known as Taking in the good. Hanson asserts that the human brain is wired to be like Velcro® for bad experiences and Teflon® for good. It takes at least 20 to 30 seconds for a good experience to register, sink in and rewire the brain into feeling more relaxed, at peace, resilient and ready to take what comes. Focusing for 10, 15, even 20 seconds periodically throughout the day on a positive experience like feeling secure, feeling tenacious or expressing gratitude can reinforce the good.
Here’s a brief exercise from RedBrick Journeys® you can try right now:
Look at your cup of coffee—now imagine all the help that got it to you, from the farmer who grew the coffee beans to the artist who designed your mug.
A few seconds well spent. In part 2 of our series, we’ll take you through a few more mindfulness exercises you can use for an immediate impact on your day—or your work group.
See part part 2 here.
1National Institute of Health. “Meditation: What You Need To Know.” December, 2007. [downloaded from https://nccih.nih.gov/health/meditation/overview.htm]
2Dane, E., and B. J. Brummel. “Examining Workplace Mindfulness and Its Relations to Job Performance and Turnover Intention.” Human Relations 67.1 (2013): 105-28. Web. 28 June 2015.
3Kissel Wigela, Karin. “Practice Mindfulness Without Meditating.” Psychology Today. Feb 18, 2010. [downloaded from https://www.psychologytoday.com/blog/the-courage-be-present/201002/practicing-mindfulness-without-meditating]
By Eric Zimmerman, Chief Marketing Officer, RedBrick Health
A recent survey of employers with more than 500 employees confirmed what many of us expected to see—a continuing rise in outcomes-based incentives programs.1 Our own survey research shows a strikingly similar trend among employers with more than a thousand employees: Many are moving to outcomes-based designs.2
It seems like a logical assumption is being made here—outcomes-based models that tie rewards to key behavioral and biometric results are likely to produce better biometric outcomes.
But is there evidence to back up that assumption?
We recently reviewed the year-over-year program results of over 80 reward designs that reached nearly 500,000 individuals. We divided the sample into four reward design types:
Here’s what we found. Engagement levels were positively associated with improved biometric outcomes. So were reward levels. (In fact the two are highly correlated, so it’s likely the effect of rewards is really the lift they create in engagement.) However, we could find no statistical evidence that participants in outcomes-based models achieved better outcomes than those in other models.2 That’s not to say it isn’t there—we just didn’t see it in this large sample.
So the answer according to this analysis is no, outcomes-based designs do not produce better outcomes than participation-based designs. That may be a relief to those who’ve felt pressure to join the trend toward outcomes-based reward designs, but were concerned about backlash.
The takeaway: If you’re going to focus on one thing, focus on what gets you real engagement in your population, whatever that might be. It’s engagement that gets you results.
1Gene Baker, G., Dermer, M., & Wolfsen, Brad. (2015, April 29). 2015 bswift Benefits Study Preview: Wellness and Incentives [Webinar]. Retrieved from http://ebn.benefitnews.com/media/newspics/ebn_bswift_042915.mp4
2RedBrick Health, Analysis of results by reward design, 2013 to 2014.
Part 3 of a 3-part series
By Nathan Barleen, Director of Research, RedBrick Health
In parts 1 and 2 of this series, we presented the case for choice for engaging individuals in their health and the role choice can play for those with chronic conditions. In this post, we’ll talk about how different segments of consumers respond to different options when offered in a choice-based health management model.
Choice allows individuals to exercise their preferences. Traditional and online merchants have studied the differences between customer segments for years. Merchants know that different marketing approaches and product types appeal to different individuals. In order to maximize sales, they often organize choices in a way designed to appeal to each segment of their audience.
Consumer engagement in wellness activities can be approached the same way. We set out to learn how different types of individuals choose to engage in wellness programs. We found that some characteristics of our consumers, like age, location, company type and geographic region, were predictors of how these individuals responded to wellness program options.
When we controlled for differences in incentives and communication we found some interesting patterns with respect to who chooses phone coaching, who selects a virtual coaching experience, and who prefers simply tracking daily habits.
It takes more than apps and wearables to reach all segments of the population
Given the choice, most of our participants selected a digital form of health engagement, but some opted for the support of a live coach. We found that those who chose to work with a live coach were more likely to be:
In contrast, our digital users (including our virtual coaching users) tended to be younger, work in a white-collar setting, and live in mid- to upper-income suburban or exurban neighborhoods. Our self-trackers (including those who chose to sync a phone app or wearable device) were our youngest users, and most likely to live in higher income and urban areas.
Seem like an intuitive finding? Maybe so. However, it’s important to recognize that the risk and healthcare cost distribution within many working populations skews toward those that, based on our research, prefer the live coaching option.
That’s a core reason why we believe that a best practice population health model offers choice, including the options to work with a coach, use a virtual coaching app or track daily activity with integrated devices. Limiting engagement options may make the path to wellness more difficult for some consumers—and some may not get on the path at all.
By Dr. Jeff Dobro, RedBrick Health Chief Medical Officer
The upward trajectory of healthcare costs has given rise to a debate about the value of annual health screenings. Are they really necessary? Do they surface enough potential medical issues to outweigh the costs of screening an entire population?
At RedBrick, we’ve screened hundreds of thousands of consumers across the organizations we serve. This experience, along with the evidence we’ve gathered, has convinced us that periodic health screenings as part of a workplace health and wellness program make sense.
Screenings can help to:
We recognize that the USPSTF and other professional organizations have very specific recommendations based on each individual’s specific health status and risks that differ from a yearly screening, yet highly personalized screenings are not practical or cost effective for large populations. Identifying common and costly risks is the first step toward increasing the overall health and well-being of your population.
Find out about RedBrick’s screening options here.
June 24th, 2015
Karin Bultman, RedBrick’s vice president of market development, participated on a recent panel at the Health Access Summit. The following is based on her presentation titled “It’s How You Say It” – Strategies for Optimizing Health Communication and Engagement. Karin offered the audience the top 10 things RedBrick’s learned about crafting engaging health communications so audience members could consider them for their own programs.
We know you invest a lot of time and money communicating health and wellness initiatives to your consumers. But are those messages helping you meet your goals? How do you ensure your communications are effective, engaging, and inspiring your consumers to better health?
The recently retired David Letterman made the Top-10 list an institution. We’re continuing the tradition with our own list, Top 10 tips for creating engaging consumer health communications:
And the number 1 tip for communications that engage and inspire consumers…
Have your own tip to share? We’d love to hear it.
At RedBrick Health we like to do what works, rather than what’s traditional. And—as it turns out—choice works. Visit the post to learn more.
Part 2 of a 3-part series
By Dr. Jeff Dobro, Chief Medical Officer, RedBrick Health
In part 1 of this series, we presented the case for choice for engaging individuals in their health. We found that by putting the person back into the personalization—letting individuals select their own healthy activities and way to interact—we were able to find equivalently strong impact on health results regardless of the choice between live coaching, virtual (or digital) coaching, and self-tracking.
In part 2 we focus on the segment of the population with chronic conditions—a group that can comprise up to 20% of the typical working population and drive up to 80% of total healthcare costs.
A traditional health management stratification design would focus on recruiting these high-risk, high-cost individuals into intensive phone coaching, and specifically into a disease management intervention. At RedBrick, we do condition management, but we let consumers choose where to place their focus. Why? Choice allows them to exercise their preferences and taps their intrinsic motivations—like improving appearance, living longer to see their kids and grandkids grow up, boosting energy, or fitting into a smaller size—that encourage engagement.
And, as it turns out, given the choice, 80% of those with a chronic condition choose to focus their coaching experience on a lifestyle issue—like nutrition, exercise, weight loss or stress. And we let them. By using a whole person approach we avoid the pitfalls of treating people as disease states, risk factors or body parts. We start with what’s relevant for them and consistent with preferences and intrinsic motivations.
Is this “choice architecture” driven approach clinically defensible? We think so. Key clinical topics are covered on every coaching call: Medication compliance and condition monitoring, working effectively with your doctor, self-management plans, health education and overall well-being. We make sure to weave in a call with a nurse to review their condition in detail during at least one out of four coaching sessions And, somewhat paradoxically, by letting people choose their focus, we end up coaching three times as many people on issues that are still highly relevant to their condition, and four times as many people in total. Using our small steps approach, we build upon each small success and drive a much broader level of clinically-relevant results than a standard disease management approach.
As it turns out, health improvement isn’t a linear process. Lifestyle habits affect chronic conditions, and a change in a chronic condition will, in turn, impact day to day lifestyle behaviors. Getting more active reduces weight, which helps mitigate blood pressure, elevated cholesterol and diabetes. Psychologically, making a single, small improvement builds self-efficacy and making consistently healthier choices helps re-shape self-perception.
When it comes to helping individuals better manage chronic conditions, start with choice.
In part 3 of this series, we’ll explore how different populations respond to different engagement modalities—and why to avoid a “one-size-fits-all” approach.