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What makes a wellness program succeed or fail? Behavior, motivation, and personality

David Mould, PhD, also contributed to this article. Intuition and recent studies have proven that […]

David Mould, PhD, also contributed to this article.

Intuition and recent studies have proven that wellness programs, which actively leverage activity trackers, are great but one size definitely doesn’t fit all. This piece explores the history of activity trackers, how they play out in wellness program and an analysis of one global company’s wellness program participation data.

Old activity trackers
Activity trackers are nothing new; indeed they have been around for a long time. A long, long time. The first pedometer is said to have been invented by Leonardo Da Vinci, as a means of tracking how far Roman foot soldiers walked. Thomas Jefferson is credited with another early version of a pedometer, and in 1965 Y. Hatano in Japan came out with the “Manpo-Kei.”

The rise in popularity of wearable technology may have been a consequence of the Calculator Watch in the 1980’s, but activity trackers and pedometers were still mostly relegated to use by athletes and physical fitness buffs. Nearly 35 years ago wearable trackers were already capable of tracking heart rate, steps, acceleration, altitude, and location (using GPS). In 2006, a former colleague competed in the Ironman Triathlon in Hawaii. He wore a GPS-pedometer so that every yard of his progress was tracked, from his location to time of day to number of steps taken. His data was downloaded and could be shown on a computer screen. Back at the office, we were able to “see” his zigzagging swimming pattern as he dodged other competitors in the ocean swim stage of the race. Later, he could study and analyze the downloaded data in order to prepare and improve his performance in his next triathlon.

There are likely several concurrent reasons for the increase in mainstream popularity of activity trackers. Ease of use and integration with other technology may be one important factor. In the early 2000s, wireless technology enabled data transmission to transform every aspect of daily life, including fitness, athletic training, and health. Another important factor is an emergent culture of personal wellness. This upsurge in health awareness is reflected in intensified marketing of personal health related items, including activity trackers. And yoga pants.

New tracking and measuring devices
Currently available activity trackers are often wearable devices that can, not only capture location and steps, but will calculate mileage, intensity of activity, calories burned, heart rate, and even how well one sleeps.

New activity tracking applications include tracking and GPS analytics for iPhones, Androids, and via the web. Fitbit has an application that compiles your data and allows you to compare and compete with our friends. A similar application called Strava, allows avid runners and cyclists to track and compare performance on specific tracts of trail or road, giving the user a ranking among other users. To complete Strava’s hard-core offering, it has a “suffer score” that visually presents exactly how hard you have been working out. Other analytics include leader-boards that compare you to others in your age and weight class.

Activity tracking and wellness programs
Increasing activity levels is one goal of wellness programs, and employers are increasingly interested in helping employees to become or stay active and healthy through engagement with these programs. Wellness programs provide support, motivation, and comradery for participants—two factors which may crucial to creating healthy physically active lifestyle (1). There are many other benefits derived from employee wellness programs in addition to enhanced personal health. Indeed, some researchers have concluded that organizational wellness programs serve to increase job satisfaction, and decrease absenteeism (2,3).

Wellness programs are taking advantage of activity tracking devices, drafting on the motivation that accompanies their use. Indeed, the simple act of keeping tabs on activity levels is found to increase an individual’s daily amount of exercise; some research has found that the use of a pedometer was associated with the health benefits of increased physical activity (4).

In May of this year MedeAnalytics began participating in a health and wellness program called Global Corporate Challenge. The goal of this program is to get employees to be more active through participation in a virtual walking tour around the world in 100 days. Teams are formed and compete against other teams within the company as well as against teams from other participating companies from around the world. The GCC program is elegantly simple; each participant is given two activity trackers (pedometers) and asked to enter their daily steps on a website. In a tech-savvy company there was some skepticism surrounding the lack of wireless tracking and manual data entry, but nonetheless company participation is nearly 65%.

We were interested in understanding what personality and motivational factors are important predictors of success (measured by improvements in activity levels or maintenance of healthy levels) in the wellness program. Roughly half of the GCC participants volunteered to be a part of our Mede/fitness and wellness survey.

Over the course of the first 50 days of the wellness program, 39% of participants showed improvements of an average of 2.4 miles. In contrast, only 11% of participants showed a decline in activity averaging 1.9 miles less than at the beginning of the program. The participants with stable step averages (with an average of less than a 0.01 mile change) were walking a very healthy average of about 5 miles per day on days 42-49 of the challenge.

Preliminary results from our survey data suggest that previous activity, personality traits, and perception of health are factors that may be influencing ongoing participation (as measured by missed step entries) in the wellness program. Moreover, some of the differences seen between those whose activity levels increased or were stable and those who showed decreases were shaped by personality factors and baseline activity. Step average in week one was strongly correlated (r = 0.75, n = 46) with the step average for week 7 (day 49 in the 100 day challenge).

By combining activity tracking data with psycho-social measures, we found interesting associations between behavior, motivation, and personality. These early results are illustrative of what intuition and anecdotes tell us — that not all individuals will respond and participate in the same way; however, by using predictive and advanced analytics to uncover where these differences occur, wellness programs can be tailored to support individuals who may have more difficulty becoming or staying more active, thereby promoting healthier lifestyles for those who may benefit most from the change.

References
1. Ståhl T1, Rütten A, Nutbeam D, Bauman A, Kannas L, Abel T, Lüschen G, Rodriquez DJ, Vinck J, van der Zee J. The importance of the social environment for physically active lifestyle–results from an international study. Soc Sci Med. 2001 Jan;52(1):1-10.
2. Parks KM, Steelman LA. Organizational wellness programs: a meta-analysis. Journal of Occupational Health Psychology 2008; 13(1): 58-68. [PubMed]
3. Gibbs, P., & Cartwright, S., 2010. (Report) Steps to health: An evaluation of the impact of participating in the Global Corporate Challenge. Lancaster University, Center for Organizational Health & Wellbeing.
4. Dena M. Bravata, MD, MS (November 21, 2007). “Using Pedometers to Increase Physical Activity and Improve Health”. The Journal of the American Medical Association 298 (19): 2296–304. doi:10.1001/jama.298.19.2296. PMID 18029834


Virginia Long, PhD

Virginia Long, Ph.D. leads predictive modeling efforts for MedeAnalytics by using big data for various provider and health plan projects. The ballerina turned behavioral neuroscientist turned data scientist is a UCLA and UC Berkley graduate with seven years of research experience.

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