Featured Articles                                                   December 2010, Vol. III, No. 8
Interactive Forum for Online Health Program Reduces Attrition, Boosts Savings

Researchers at the University of Michigan Medical School have found that adding an interactive online community to an Internet-based walking program significantly decreased the number of participants who dropped out. The findings show that adding community features to online health programs can be a powerful tool for reducing attrition, said the researchers. The approach also has the potential to produce significant savings compared to traditional interventions, such as face-to-face coaching, which are expensive to do on a large scale.

Seventy-nine percent of participants who used online forums to motivate each other stuck with the 16-week program. Only 66 percent of those who used a version of the site without the social components completed the program. Still, both groups saw equal improvements in how much they walked while using the programís Web interface to track their progress — about a mile per day. For health programs with a national or international scope, even small reductions in attrition could lead to positive health outcomes for large numbers of people and significant system-wide cost savings.

A second, complementary study analyzed which strategies were most successful at garnering social interaction. Among the recommendations based on the findings:

  • Use a small number of conversation spaces rather than many specialized ones.
  • Have staff respond to user posts when other users donít and post new topics when there is a lull in the conversation.
  • Conduct contests with small prizes.

While one-on-one interventions can cost hundreds or thousands of dollars, the Web-based approach has the potential to deliver similar results at a much lower cost. An online health program is somewhat expensive to set up, but becomes cheaper on a per-person basis over time and as the size of the program increases. Plus, much of the content is provided for free by participants as they share tips and encouragement.

As social media networks become even more integrated into the fabric of American life, there will be additional opportunities to harness their power, encouraging participation and disseminating information at a low cost by piggybacking on that existing infrastructure.

Get more information here.

Quotable: Program Engagement & IT

"Convenience is critical when it comes to engaging members or patients in a daily self-care program. Engagement is higher when that intervention is delivered via technologies and resources that the consumers are using on a daily basis for other purposes."
                                        — Dr. Randall Williams, Pharos Innovations

Learn more about health IT in care management.

Behavior Change Video Games Improve a Childís Diet

In a new study published in the January 2011 issue of the American Journal of Preventive Medicine, researchers found that video games designed to encourage such behaviors as fruit and vegetable (FV) consumption, increased water intake and increased physical activity to lower the risk of obesity in youngsters were effective.

"Escape from Diab" (Diab) and "Nanoswarm: Invasion from Inner Space" (Nanoswarm) are epic video games specifically designed to lower risks of type 2 diabetes and obesity by changing youth diet and physical activity behaviors and are based on social cognitive, self-determination and persuasion theories.

"Diab and Nanoswarm incorporate a broad diversity of behavior change procedures woven in and around engrossing stories. The games motivated players to substantially improve diet behaviors," according to lead investigator Tom Baranowski, PhD, professor of pediatrics, U.S. Department of Agriculture/Agricultural Research Service supported Childrenís Nutrition Research Center, Baylor College of Medicine.

In this randomized clinical trial, 153 children ages 10 to 12 years, were divided into a treatment group (103 children) and a control group (50). Complete data were obtained on 133 subjects. The treatment group first played Diab and then Nanoswarm. The control group played diet and physical activity knowledge-based games on popular Web sites. Each group was assessed at the start of the trial, immediately after Diab, immediately after Nanoswarm, and again two months later. Height, weight, waist size and triceps skin-fold thickness were measured. Physical activity was monitored for at least four days by accelerometer-based data from each child at each assessment. Food consumption was measured using 24-hour dietary recalls conducted by registered dietitians.

Children playing these video games increased FV consumption by about 2/3 serving per day, but did not increase water consumption or moderate to vigorous physical activity, or improve body composition. Despite the increase, FV and water consumption and physical activity remained below the minimum recommendations.

The games were designed by Archimage, Inc., and funded by a Small Business Initiative Research Grant from the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health.

Read the full article here.

Health Risk Assessments: Administration, Delivery and Completion Benchmarks
Who's using health risk assessments (HRAs), and how are they administered? What are the top incentives driving HRA completion, and what are the top three uses for HRA data? What completion rates can be expected?

In this month's healthcare benchmarks podcast, Healthcare Intelligence Network executive VP and COO Melanie Matthews shares the latest market research on HRA use. This month's metrics are derived from HIN's June 2010 survey on HRAs, with commentary from Dr. Marcia Wade, Aetna Medicareís senior medical director.

Listen to the podcast here.

New Chart: Top Health Coaching Tech Tools

With so much technology available to wellness and health promotion programs, we wanted to see which IT tools are supporting organizations' health coaching programs.

Click here to view the chart.

Integrating PAM into Telephonic Coaching

Question: What is the best way to integrate the 13-question Patient Activation Measure (PAM) into telephonic programs, given that it may be perceived as too long?

Response: We are administering the tool telephonically. It takes about three to five minutes and you may have to repeat one or two of the questions. Sometimes we get people who put a lot of thought into it, which is a good thing, but even so it still does not take that long. Our engagement of people who are administering the survey feel that only introducing the program and getting people to agree to participate is probably enough for one phone call, because if we hand them off to a nurse who is going to do a clinical assessment, they could be on the phone for 20 or 30 minutes. That can be overwhelming for people.

(Diane Bellard, R.N., M.S., director of disease management and wellness services for American Health Holding.)

Learn more about different health coaching programs.

HCH Readers Save 10% on Coaching Resource

Feeling the squeeze from softening service demands, growing competition, reimbursement cuts and increased regulatory oversight, the healthcare industry is ripe for financial relief. Will the coming year offer any respite from lingering economic and social malaise? In Healthcare Trends & Forecasts in 2011: Performance Expectations for the Healthcare Industry, two key thought leaders tackle these questions and more as they look ahead to healthcare reform 2.0 — implementation and rollout.

HealthCoach Huddle subscribers should use ordering code HCH to purchase this product at a special price!

Get more information on future healthcare trends.

2010 Telehealth Benchmarks

This white paper captures the nuts and bolts of telehealth services offered by 111 healthcare organizations who responded to HIN's September 2010 Telehealth and Telemedicine survey, including top technologies, targeted populations and prevalence of remote monitoring.

Download complimentary white paper here.



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