Healthy Behaviors Are Contagious

1 Copyright © 2012 ShapeUp, Inc. Confidential & Proprietary.


Luke Matthews, Ph.D.

Director of Data Analytics

Activate Networks

Tricia Leahey, Ph.D.

Asst. Professor of Psychiatry/Human Behavior

Weight Control & Diabetes Research Center

Rajiv Kumar, M.D.

Founder & Chief Medical Officer

ShapeUp

Today’s Presenters


ShapeUp’s Mission Statement

Creating a healthier world by

leveraging social influence to

engage people in healthy activities


1. Spread of human behavior in

large social networks

2. Social influence in a team-

based wellness program

3. Implications for population

health management

4. How you can leverage this

knowledge to achieve

success

5. Questions & Answers

Today’s Agenda


Spread of Human

Behavior in Large

Social Networks


Luke Matthews, Ph.D.

Director of Data Analytics

Activate Networks


• Our management team has built/led large health

companies

• 15 years of research from Harvard and UVA

• National acclaim from “Connected”

by co-founder Dr. Nicholas Christakis

Harvard Innovation, Deep Health Expertise


• Lifestyle behaviors (good & bad)

• Clinical practice patterns

• Medication use

• Fraud & criminal behaviors

• Consumer purchasing decisions

Human Behaviors Are “Contagious”


Health Is Collective


Obesity In The Framingham Heart Study

N. Christakis and J Fowler, The spread of obesity in a large social network over 32 years. New Engl Med 2007 357:370


Obesity In The Framingham Heart Study

N. Christakis and J Fowler, The spread of obesity in a large social network over 32 years. New Engl Med 2007 357:370


Spreading Contagions In Networks


Smoking In The Framingham Heart Study

N. Christakis and J Fowler, The collective dynamics of smoking in a large social network. New Engl Med 2008 358:2249-2258


N. Christakis and J Fowler, The collective dynamics of smoking in a large social network. New Engl Med 2008 358:2249-2258

Smoking In The Framingham Heart Study


Other Network Effects On Health

Obesity Christakis NA, Fowler JH (2007) The New England

Journal of Medicine 357: 370-379.

Smoking Christakis, N.A. and J. Fowler. (2008) The New England

Journal of Medicine 358: 2249-2258.

Alcohol Rosenquist J.N., J.H. Fowler, J. Murabito, and N.A.

Christakis. (2010) Annals of Internal Medicine 152, 426-

433.

Depression Rosenquist J.N., J.H. Fowler, and N.A. Christakis. (2011)

Molecular Psychiatry 16:273-281.


Map and identify employees

Most influential, “influencees,” influence patterns

Overlay health information

Health behaviors, participation in programs

Highly focused outreach

Two basic network engineering techniques

Build new ties and plan teams

Target key influencers

Activate Networks Wellness Technology

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Node size reflects BMI

Nodes are dots if the

individual did not

engage in program

Target The Key Influencers

BMI significantly correlates across network ties, even after accounting for

location and rank.

(Matthews et al. in revision)


Network approaches can help with the two key issues

in corporate wellness programs

Engagement

Using network effects will increase engagement and

participation

Sustainability

Using network effects will help participants maintain their

engagement and activity

Key Takeaways From Our Research


Social Influence

In A Team-Based

Wellness Program


Tricia Leahey, Ph.D.

Assistant Professor of Psychiatry/Human Behavior

Weight Control & Diabetes Research Center

The Warren Alpert Medical School of Brown University


Why We Conducted This Research

• There is strong evidence that obesity

spreads through social networks

• Given our focus on weight reduction,

we aimed to investigate whether

these same social influence

processes can be harnessed to

promote healthy behavior change

• No one had examined whether the

social component of wellness

program enhances outcomes


• Annual workplace-based campaign to

promote exercise and weight loss

• Thousands participate each year

• Team competition (5-11 members)

• 12 week online program includes

personal and team progress tracking,

weekly newsletters, community events

• Yields significant weight losses (-3.7kg)1

and increases in physical activity

(+2,300 steps)2

About Shape Up Rhode Island

1Wing et al., Obesity, 2009; 2Leahey et al., Prev Med, 2010


The Team Effect For Weight Loss

• Team members influenced individual weight loss

outcomes

• Individuals on the same team achieved similar

weight losses (ICC = 0.10)

Leahey et al., Obesity, in press


• Effects of team

characteristics on

individual weight loss

Those who reported

greater teammate social

influence for weight loss

had higher weight losses

Having more teammates

in the weight loss division

yielded greater weight

losses

Optimal Environment For Weight Loss



• Team membership also influenced

the odds of achieving a clinically

significant (i.e. 5%) weight loss,

which is associated with reduced

risk for cardiovascular disease

and diabetes

• Achieving a 5% weight loss

clustered within teams (ICC=0.09)

Clinically Significant Weight Loss



• Effects of team

characteristics on

individuals achieving

a 5% weight loss

Greater social influence

for weight loss increased

the likelihood

Having more teammates

in the weight loss division

increased the likelihood

Optimal Team Characteristics



• Team members influenced

individual physical activity

outcomes

• Individuals on the same

team achieved similar

increases in physical

activity (ICC = 0.09)

Team Effect For Physical Activity

Leahey et al., Prev Med, 2010


• Team characteristics

influenced individual

activity outcomes

Individuals on teams

that had high levels of

activity within the first

two weeks of the Shape

Up program achieved

the greatest increases

in activity

Optimal Team Characteristics

Leahey et al., Prev Med, 2010


• Social networks impact weight loss and physical activity

• Wellness programs should tap the organic social influence potential of coworkers, friends, and family to enhance weight loss and activity outcomes

Ensure that everyone on the same team is working towards a similar

health goal

Set team goals to maximize social accountability and encourage

regular reporting of individual progress

Promote a culture of social support and cohesion among team

members by offering teambuilding activities

Key Insights From This Research


• Conduct a randomized trial comparing an “optimal” team environment to an “average” or “poor” team environment and examine the effects on weight loss and physical activity outcomes

• Further examine the social influence processes by which social networks impact health

Social norms

Social modeling

Peer accountability

Social support

Next Steps For Our Research


Implications For Population

Health Management


“…Social influence also suggests that it may be possible to

harness this same force to slow the spread of obesity.

Network phenomena might be exploited to spread positive

health behaviors.”

-Nicholas Christakis, M.D.

Turns Out Dr. Christakis Was Right



Health behaviors, like many other human behaviors,

spread in social networks

Unhealthy outcomes that spread include obesity and

alcohol consumption

Healthy outcomes that spread include smoking cessation,

increased physical activity, and weight loss

Interventions that target key influencers are more likely to

achieve maximum engagement and activity

Interventions that promote social influence, teamwork,

and shared goals are likely to produce better outcomes

Key Takeaways from Today’s Webinar


How You Can Leverage This

Knowledge For Success


How You Can Leverage Social Influence

• Map the social network of your population

• Facilitate peer-to-peer recruitment through influencers

• Focus on organizing teams and groups for wellness

• Promote teamwork and peer support

• Utilize competitions to organize & motivate

• Share results & comparisons to promote accountability

• Link incentives to team goals and team outcomes

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Take Our Health + Technology Survey!

• How is technology shaping the way

you help your employees manage

their health?

• 10 minute online survey

• Chance to win a Fitbit activity tracker!


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Healthy Behaviors Are Contagious

Health & Medicine