WLSACONVERGENCE SUMMIT

FITTLE: IMPROVING WELLNESS THROUGH A MOBILE SMART PHONE PLATFORM

HONGLU DU

Fittle: Improving Wellness through a Mobile Smart Phone PlatformHonglu Du (hdu@parc.com), G. Michael Youngblood, Peter Pirolli

Palo Alto Research Center (PARC)

Wireless Health 2014

10/30/2014

The Challenge

Example: Kaiser Permanente Hawaii

Long-term maintenance problem * Bottleneck in servicing members Geography

*: Foster GD, Wyatt HR, Hill JO, Makris AP, Rosenbaum DL, Brill C, et al. Weight and Metabolic Outcomes After 2 Years on a Low-Carbohydrate Versus Low-Fat Diet: A Randomized Trial. Ann Intern Med. 2010;153:147-157. doi:10.7326/0003-4819-153-3-201008030-00005

Background Science• Lifestyle change = Progressive

mastery of healthy habits.

• Psychology has studied habit formation and extinction for 100 years

• Theories of individual health behavior

• Goal Setting Theory

Too Hard

Too EasyOptimal F

low

AbilityLow High

Ch

alle

ng

eLo

wH

igh

Method

- 19 participants recruited ‣ Diverse background

‣ 8 in nutriwalking, 11 in stress busting

‣ Used Fittle for 8 weeks

- Pre and Post surveys‣ Theory of Planned Behavior

‣ Health outcome measures(Healthy Eating, Stress, Physical Activity Level, Sleep Quality)

- Log ‣ Weekly compliance

‣ Messages posted

- Interviews

Efficacy of Fittle : Results of ANCOVA

Stress Healthy Eating Sleep Quality1

2

3

4

5

6

7

2.61

4.10

2.132.28

4.61

2.17

Pre Post

Physical Activity Level0

50

100

150

200

250

300

350

400

260

356.84

p= 0.02Cohen’s d = 0.61

p= 0.02d=0.58

p= 0.001Cohen’s d = 0.85

Efficacy of Fittle for NutriWalking: ANCOVA

Stress Healthy Eating Sleep Quality1

2

3

4

5

6

7

2.41

3.81

2.322.46

4.63

2.29

Pre Post

Physical Activity Level0

50

100

150

200

250

300

350

116

273

p= 0.03d= 0.91

p= 0.008d=1.28

Efficacy of Fittle for Stress Busting: ANCOVA

Stress Healthy Eating Sleep Quality1

2

3

4

5

6

7

2.75

4.33

2.042.15

4.58

2.01

Pre Post

Physical Activity Level0

50

100

150

200

250

300

350

400

450

376

418

p= 0.06d= 0.5

p= 0.005d = 1.16

Fittle Usage Model

Page-Gould, E. (2016). Multilevel Modeling. Invited chapter to appear in J. T. Cacioppo, L. Tassinary, & G. Berntson, The Handbook of Psychophysiology.

Pre attitude Toward the Challenge

Fittle usage: # of Messages and

High Fives

Perceived Usability of the

App

WeeklyCompliance

b=.007 ***

b=.13 ***

b=.05 ***

Intra class correlation: 37%

Team Effects

Achievement of Group Weekly Goals

7

4

1

3

2 2

Week

Com

plia

nce

Rat

e

Conversational Activities: comparing high & low success teams

- Participants from high success groups interacted with their team members much more than the participants from low success groups.

Summary

chi-square(4) = 17.80, p = 0.001

Take-away messages

Group Influence

Group have a positive impact on individual members’ compliance.

Medium to large effect sizes achieved

The gains on test scores of healthy eating, physical activity, and stress all showed medium to large effect sizes (Cohen’s d = .58 to .85).

Future Work

- Teaming ‣ Randomized controlled trial to study the effects of teams

‣ Study different ways to form teams

- Adapting challenges to the user ‣ Recommend personalized progressive daily activities to the user

- Predictive model of behavior change

Stories we heard

“Literally, in about 15 years, for the first time I have managed to get below the threshold that I have never been able to get to. “- P1001

“One time I went to an amusement park, and it was the first time that I ever went to an amusement park and I didn’t eat a fried food. I told everybody hey, you know this is the first time I ever went to an amusement park and did not eat a fried food because I was consciously thinking I need to eat healthy and I really did not go toward any unhealthy food. “- P1006

“I actually see a practically dramatic improvement. I have lost about 7.5lbs since I started Fittle. I have seen significant changes in my own body.”- P1011

WLSACONVERGENCE SUMMIT

www.wirelesshealth2014.org