dailyfeats wants to be a “positive action platform for the world.” the way they’re tackling this mildly ambitious goal is by encouraging users to take one small, positive action. CEO and co-founder veer gidwaney spoke with me about their goals, partnerships and future possibilities in the employer space.

fm: what is dailyfeats going after?
vg: the biggest social challenges we face are going to be solved because people change how they live their lives on a daily basis. we believe the biggest opportunity lies in helping people take on positive actions and celebrating those actions with them.

fm: when i use dailyfeats, what do i do? do i set up goals?
vg: no—no goals. we want to help people create new habits one small step at a time. when people use dailyfeats, they complete small actions that range from tackling their to-do list to eating more vegetables to practicing safe sex. along the way, they earn points, share with friends, and treat themselves or others to real-life rewards, motivating them to keep up the good work. at dailyfeats, we aim to make positive actions part of people’s everyday lives by helping them celebrate their “feats” and reach their potential.

fm: can you give me an example of how i’m rewarded?
vg: the team at jawbone asked to partner with us with their new device, jawbone up. we created a challenge with them, a defined set of actions a user needs to complete within a set period of time. the device authenticates that you actually completed them. and when you do, you get bonus points that have a monetary value and that are automatically integrated with your dailyfeats account.

fm: i understand you have sponsored partnerships. why?
vg: if we’re going to touch millions—to inspire millions to change—we know we need to have a strong voice. we’re competing with the couch. we know that for-profit and nonprofit organizations have the strongest voice, so we partner with them. we invite them to join our coalition for good.

for example, cigna is our exclusive health services partner this year. they sponsor certain activities you can complete daily, activities like eating more fruit, taking a walk or completing a wellness assessment. walgreens is another partner. we have an in-store text-based campaign that’s going live with them this year. it focuses on healthy kids. when you’re in the store, you’ll see placards that advertise this campaign. you can use your phone to get a list of things you can purchase and redeem a gift certificate for walgreens. people do something good for themselves and save money, it’s good for the walgreens brand, and as a society, we see better collective behavior.

fm: dailyfeats is strictly consumer-facing right now. do you have plans to enter the employer market?
vg: clearly dailyfeats could be very powerful in the employer space. the way we’re pursuing it right now is through our health plans partners. we’re exploring how they can bring us to employers.
we’ve run pilots with certain partners and in certain markets. we’ll be working with human resources and our health partners to customize activities per the employer’s focus and create challenges that can be framed around their particular health risks.

fm: your goal is very ambitious. how are you measuring your progress toward achieving it?
vg: we measure by the sheer number of positive actions people are taking.

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read more free-ranging conversations with health innovators.

hellowallet is an enterprise solution that employees can use to wrap their hands around their financial situation and improve it. i spoke with paul ballas, head of user experience at hellowallet, to understand the service and hellowallet’s mission to “democratize financial guidance.”

fm: why hellowallet? what’s the idea behind the service?
pb: matt fellowes, the founder and CEO of hellowallet, was working at the brookings institution, focused on consumer finance. he’d worked with the FDIC on 401(k) auto-enrollment, and he found that it was positive but didn’t go far enough. people opted out, people took loans and didn’t pay them back. matt wanted to offer a service that’s unbiased and conflict-free.

fm: how exactly do you help consumers budget better?
pb: let’s say you’ve created your online budget with hellowallet. we know you have a mortgage and see that you haven’t dedicated any money to home repair. we’ll remind you what to consider. or, let me give another example. you can emotionally flag transactions with hellowallet. if you wished you hadn’t bought a cup of coffee at starbucks, you can tag it: “wish i hadn’t bought this.” the next time you’re at starbucks, we’ll send you a reminder that you said you wished you hadn’t made the purchase last time. we nudge people from where they are and gently move them in the correct direction.

fm: the starbucks example’s interesting. does hellowallet recognize where i am?
pb: yes. our companion iphone app allows users to check into a location. when you’re in starbucks, the app will know you’re in a coffee shop, how much you’ve budgeted for coffee and how much you’ve spent to date.

fm: i outsourced the creation of our budget to my husband. he loves spreadsheets. most of us don’t. how easy is hellowallet to set up?
pb: we have two options. one automatically links to your financial accounts—your checking, savings, 529 plan—and pulls in your data. it’s read-only, so you can’t move money from account to account through hellowallet today, for example, but you can look at your budget. if someone doesn’t want to link their accounts, they can manually enter transactions to keep their budget and accounting current.

we provide webinar training to employees so they understand the tool. we also go onsite to train employees at benefit fairs.

fm: i assume there’s an additional setup step where i need to say what my today and tomorrow financial goals are. how does this happen? what’s involved from the employee’s perspective?
pb: we help employees create their budget and retirement goals. we’ll ask about income constraints, such as mortgage, car loans, other debt. over time as we see trends, we’ll see where someone is overspending or over-budgeted. we’ll ask if they want to shift money from where they’ve budgeted too much to where they’re overspending, or to cut back on overspending.

this isn’t static. we’ll nudge employees forward. we do what employees want first and then bring in other goals that are equally important down the road.

fm: are you finding that this tool works better for one group of employees than another?
pb: we launched in april 2011, so it’s too early to tell. however, it’s designed so that someone with a high school diploma or a person with a graduate degree can easily use it. today only 20% have access to financial consultants. our mission is to democratize financial guidance. to that end, we donate a subscription to hellowallet to a family in need for every five subscriptions we get.

fm: since you’re an enterprise solution, do you customize the tool based on the employer’s known data? for example, would your tool reflect whether i’m enrolled in the dependent care flexible spending account (FSA) or if there’s a health plan that’s best for my budget and health needs?
pb: we’re starting to. we can say, “fran, we know you’re spending $X on child care and we know X company offers an FSA.” we also have a dedicated research team that’s focusing on how to link hellowallet with health care guidance.

hellowallet will be joining the february 15, 2012 #co_health chat. 

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read more free-ranging conversations.

back in april 2011, i spoke with tom abshire about virgin healthmiles’ pay-for-prevention approach. since our conversation, virgin’s added several new features to their platform that benefit employee and employer alike. they released an integrated incentives platform in their summer ‘11 release and enhanced social features in their fall ‘11 one. i caught up with katie tierney, virgin’s director of marketing, to learn more about both.

fm: your fall ‘11 release includes several new features. one, connections, allows employees to build social support networks. can you explain how connections works?
kt: social’s always been a key element of what we do, but now with connections we’ve created a network that’s secure and members-only. employers can make it possible for employees to create groups around common activities and interests within their organization, and they can also open their network to virgin healthmiles’ entire member network. employers can add connections to their existing programs too. for example, employers can create a group specifically for their employees participating in a tobacco cessation program or use connections to augment their health coaching service. their health coaches can create groups and offer one-to-many health coaching in addition to their one-to-one support.

fm: when i spoke with tom in april, you were starting to explore employers’ interest in opening their networks to others in their industry or geography. does connections reflect that employers are ready? how are your client companies using connections: open or closed?
kt: in many cases we’re finding clients are immediately opening their networks. they want to drive even higher engagement in their programs, so they want employees to connect with others outside their organization yet within this members-only social health community. others are taking a more conservative approach and rolling connections out within their organizations first. it’s flexible. we leave the decision in the hands of our clients.

fm: what sorts of groups are employees forming?
kt: we only recently released connections, so we’ll be able to share more stories over the next few months. right now, we’re seeing employees form groups around sports, nutrition, healthy recipe exchanges, locations, walking clubs. one that caught my attention is for single mothers. it focuses on how they’re finding time to exercise and be healthy.

what’s really exciting is to see how members are responding. in just a month’s time, we’ve seen members make more than 84,000 friends, form nearly 3,000 different groups, and post nearly 6,000 status updates or comments. since the launch of connections, we’ve seen more than a 100% increase in the number of challenges members are creating and running themselves at any given time.

fm: you also announced something called “active minutes.” what’s this?
kt: active minutes helps employers keep things simple with one program that fits all fitness levels. with active minutes, employees can earn rewards for any activity they do while using our pedometer or other compatible activity-tracking device, such as a polar heart rate monitor. some employees might prefer to do 15 minutes of vigorous activity versus 30 minutes of moderate activity like walking. either way, their activity rate is validated and automatically uploaded into our system. we’re also looking at additional devices so people can use the tool that works best for them.

fm: how is active minutes different from virgin’s level system, where employees move from level one to level five, slowly increasing their activity level and earning points as they go?
kt: active minutes actually works with our levels program. active minutes offer employees another way to track their activity–specifically, more vigorous workouts–and track them in real-time and over time. if they’re participating in and tracking vigorous activity, they’ll progress through the levels and earn rewards even faster.

fm: with your summer ‘11 release, you announced integrated incentives and better data reporting. can you refresh our memory on what these offer?
kt. with summer ‘11, we wanted to focus on providing employers with a streamlined way to integrate and promote their multiple employee health programs and to give them the information they need to know their impact. what we introduced was integrated incentives and a real-time reporting portal. with integrated incentives, employers can decide what programs to integrate into our platform, even when they’re from different providers.

say an employee earns $100 for completing his or her health risk assessment , $50 for a biometrics screening and a day off for smoking cessation—and all are through different providers. with integrated incentives, we provide one central location where employers can promote and manage all these programs and employees can see all the earning opportunities available to them. then with real-time reporting, we provide information on utilization rates, physical activity levels, incentives earned and redemption trends from all these different programs and vendors, and we can segment this information based on age groups, departments, locations, etc.

• read the full press release on fall ‘11 and summer ‘11.
• read more free-ranging conversations.

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limeade is a corporate wellness provider that prides itself on innovation, keeping things fresh and making wellness relevant. they recently announced their platform’s support for commercially-available health devices and apps, such as runkeeper and nike+, making limeade effortlessly work with employees’ preferred devices. i asked henry albrecht, limeade’s CEO, to walk me through the what and why of this decision.

fm: why did you decide to do an API (application programming interface)? we’re seeing that more in public health, but not in workplace wellness.
ha: some of our big clients and prospects were telling us they wished their people didn’t have to log in to a web platform every day. some of their people aren’t sitting in front of a computer. then we also had clients who wanted to use all of the existing cool devices with their program.

we knew we had to come up with something simple. the innovation in devices and apps is coming from a million different directions. we wanted to pull that consumer innovation into our platform—one partner or one app simply wasn’t going to meet the needs of the market. we needed to come up with an approach that was easy and had broad coverage.

fm: how does this do that?
ha: many people have an app or device they love already. our service lets them connect it to their limeade account. then, if there’s a fitness challenge that’s enabled for devices, they don’t have to log in. they just use or wear their app or device. we make limeade their program.

fm: walk me through how an employer would integrate these devices into a challenge.
ha: the participant’s home or find challenges page will guide him or her to device-enabled social challenges.

he or she can choose from the available devices and apps to track progress.

once the device is enabled, the participant’s data is automatically refreshed the next time he or she logs in.

fm: how did you pick the devices and apps you’re initially partnering with, like nike+?
ha: we wanted some that were free. we wanted the ones that were in highest use in corporate america. and we wanted them all to be fun. that’s where nike+, runkeeper, fitlinxx actiped, etc., come from. employees have different budgets and different levels of interest in exploring mobile wellness.

some employers came to us and said they don’t believe in self-reported fitness data. many of these devices have algorithms that determine real activity. so, for some employers, this is also about having more verifiable data.

fm: you also recently announced an alliance with health dialog.
ha: we’ll have more to say on that soon. that announcement and this one about the limeade open app and device platform and API are examples of limeade’s track record of innovation. if you go back to 2006 when we launched, our well-being assessment was unique and novel in its inclusion of nonphysical categories like culture and trust in senior leadership. we built social networks into our platform from the beginning. we think this device platform is just one more example of our track record of cutting-edge innovation.

fm: any other innovations in the pipeline we should know about?
ha: we started in a great place with activity and fitness devices. at limeade, we love to compete for points and social and financial rewards, and we’ve seen our high-performance customers and their employees love it, too. we also see a not-too-distant future where self-tracking for stress, depression and chronic diseases like diabetes and COPD use fun, consumer-friendly apps and devices. apps will get smaller, faster, easier, more wearable and more game-like. our agile development methods will help us use our customers’ spoken and unspoken needs to tell us where we need to go next.

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read more free-ranging conversations with health innovators.

virgin healthmiles offers “pay for performance” health and wellness solutions they call pay-for-prevention™. employees who use their system rack up personal rewards while their company does the same in the form of reduced medical costs and increased productivity. launched in 2006, virgin healthmiles is now offered by more than 120 industry leaders and reaches 700,000 employees in the U.S.—their domain. i spoke with tom abshire, virgin healthmiles senior vice president, marketing and member engagement, about why virgin healthmiles has been so successful.

fm: can you explain your philosophy?

ta: in the U.S., companies are trying to balance culture, strategy and short-term goals to create healthier workforces and lower health care costs. we try to help them achieve these goals.

studies show health care costs are increasingly affecting organizations’ profitability. many projections point to health benefits costs soon equaling the costs of wages. companies and their employees can’t sustain these costs, and that’s where virgin healthmiles comes in. our program focuses on prevention—helping employees get and stay healthy. essentially, we’re applying a causal model to health care by helping employers reward their employees for healthy behaviors. we think of it as creating the equivalent of a “good driver” discount in health care.

our program includes a variety of verifiable measurement devices, including an uploadable USB pedometer and biometric measurement stations, and a tailored program to increase daily physical activity. given the disease prevention value, if you put physical activity into a bottle, it’d be a wonder drug. while it’s not the be all and end all, it’s a linchpin of a healthy lifestyle.

fm: your approach is called pay-for-prevention. what do you pay me?

ta: employees earn rewards for validated physical activity or biometric improvements.

we work with employers to develop specific incentives and rewards criteria that align with their goals. our rewards range from a few hundred dollars to thousands. typically, when you’re in the range of $1,500, you’re talking about health insurance premium reductions. just a handful of our clients are giving away thousands. the average incentive is over $300. there are still a lot of water bottles with other programs we see in the market; they aren’t very compelling incentives.

fm: how do the incentives for physical activity or biometric improvements work?

ta: with our “levels program,” for example, everyone starts at level one and proceeds to level five. level three involves getting 7,000 steps or 30 minutes of physical activity five days per week. some people are more active. they’ll get to level four or five more quickly. employees earn points by reaching the activity requirements for each level.

our biometric measurement kiosks take body fat, weight and blood pressure. employees get rewards for taking their measurements once per month. they also get bonus rewards for improving or reaching ideal biometric levels.

for a long time we’ve also provided rewards for employers’ other wellness tasks, like completion of a health risk assessment. we recently improved our process to offer an integrated incentives platform that aligns rewards for behaviors and outcomes with an employer’s additional programs, too.

fm: how do you respond to those who say giving money saps intrinsic motivation?

ta: we bring our consumer roots to this problem. (virgin healthmiles is part of sir richard branson’s virgin group.)

people are complex and motivated by different things at different points in time. we try to provide a rich environment with all of the recognized motivators, including team challenges, social, monetary.

a $500 incentive may be what’s needed to get you out of bed on a cold morning. then again, i’m currently in a team competition. i have to pay $1 when i don’t reach my daily target. the social accountability’s helping me prioritize time today.

fm: how do you tie in these other motivational and behavioral strategies?

ta: we leverage tracking, measurement, incentives, information, nudges and social motivation.

with the levels design, employees know how they’re doing against their goal and what their incentives are for these activities. it’s also validated data, so it’s a true picture of what they’ve accomplished. a lot of programs today rely on self-reported data. we know from research when we recall and report our own data, it’s often “the better us.” with our uploadable USB pedometers and networked health measurement kiosks, employees are looking at how they’re actually doing.

in terms of social, we give people different opportunities to participate. we have about 1,000 different member-run challenges going on at any given time, most with five to seven other members participating. people are challenging their peer group. they design the challenge. we give employers different ways to build the challenge and then help them communicate and market it.

we also have member blogs where people post their stories. there’s a lot of new research showing that people are looking for stories of others like themselves—for motivation and to better understand the successful approaches that have worked for similar people.

we’re working with clients to determine whether they want to maintain privacy within their employee group or open and blend with others. it’s their choice. it’s a potentially growing trend, to work across industry, geography or businesses. this is a great opportunity to start a discussion on the impact of communities and social networks.

fm: do you have plans to take virgin healthmiles global?

ta: unfortunately, chronic diseases are fast becoming America’s “biggest export.” the global market will be attractive to us.

we work with global clients. but we’re proving our theories first here in the U.S.

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• more free-ranging conversations with wellness innovators

janet mcnichol is the human resources director at ASHA. i met janet through twitter because of our shared interest in workplace wellness. janet’s been a vocal, vibrant member of the cohealth community and has shared with us the way she’s approaching wellness at ASHA. you can sum up that approach with these words: open, transparent and innovative.

fm: when and why did ASHA get into wellness?

jm: we started after we noticed in our claims report that a lot of people have high blood pressure. we thought if we made tracking it convenient, more people would do it. from there we added flu shots, a wellness fair. we stayed at this level until we moved into our new building, where we built a group activity room to hold classes. now, we have three per day: 7:30, 4 and 5. then we decided to launch some campaigns based on our health needs. we had the biggest loser, the biggest mover and a diabetes campaign last year. we’re completing another weight loss campaign and moving into a heart health campaign. we have fun. we’ve played frisbee golf, offered a kettleball class, and we recently started a hooping class.

fm: how have you decided what to offer or foster?

jm: we recently switched to unitedhealthcare, and we now have health risk assessment data. it gives us some information about the level of compliance with preventive health services we didn’t have before. the health risk assessment information was consistent with what we already knew from analyzing our prescription drug claims. we also look at trends that may affect our workplace. as part of HR’s annual goal-setting process, we read articles, studies and forecasts and then we mind-map the highlights and our observations. this year we talked quite a bit about healthcare and wellness.

fm: i noticed you wrote about this meeting on ASHA’s wellness blog.

jm: i share a lot of the behind-the-scenes work on the blog. i hope our experience can be helpful to other employers with a workplace wellness program. i also hope to engage people in our program. i love it when people comment and offer suggestions. one of my posts was about starting a wellness book club. a number of people recommended books to me after reading the post, which is how i found food rules, the book i chose for our first discussion.

fm: you covered your thinking about the book selection on ASHA’s wellness blog. what are you hoping to accomplish here?

jm: our first book club discussion is scheduled for april 28. dozens of people have borrowed copies of food rules from our HR library and more than 30 people RSVPed they’ll attend the discussion. i’m excited about the level of interest. i know many of our staff are avid readers, so i thought a book club would be appealing.

we recently redefined our definition of wellness to include four branches: fitness of body, soundness of mind, sense of purpose and mindset of sustainability. we feel the book club will provide an opportunity for us to expand our learning in these areas.

fm: you’ve also created a facebook page for ASHA’s wellness effort: inside workplace wellness at ASHA.

jm: i actually started the facebook page after a cohealth tweet chat! we spoke about getting family involved. i had no way to reach the family because our information’s on the intranet. i decided to create the facebook page so more people could see it. plus, it’s friendlier, especially for people who are already on facebook.

fm: how have people responded to it?

jm: it’s hard to get people’s attention. we share information about our wellness program on our intranet, via email, with signs and bulletin boards; there’s even a giant red blowup heart in our office to advertise our heart health program.

facebook’s just another tool for communicating. we share articles we think might interest our staff and their families. we also post announcements about wellness-related activities and events.

i like that it gives us an opportunity to reach our staff’s family. and  i like the informality and opportunity for people to comment and share information they find interesting. feedback from the staff has been positive.

fm: there’s a lot of concern about privacy when you combine social media and health information. what’s been your experience?

jm: we haven’t faced any issues about privacy.  we do have social media guidelines for our staff. they provide some general guidance and suggestions. i have a high degree of trust in the people i work with.

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it should come as no surprise that wellness permeates clif bar. after all, clif bar is all about wellness, whether that’s wellness for the individual, the business, the community or the earth. they offer the expected employee wellness services: nutritional and life counseling, employee assistance services, an onsite gym, financial lunch and learns, concierge services. then they veer way off. free personal training and discounted masseuse. sustainability benefits that subsidize bike purchases and eco-home improvements. and there are additional rewards for employees who commute via foot, train or any non-car form of transit.

jen freitas, clif bar’s HR manager, spoke with me about how they think about wellness and what it has to do with their five aspirations—their five bottom lines. of course, i had to ask the first question on anyone’s mind…

fm: do you have any employees who aren’t healthy?

jf: well, we do have over 250 employees, and not every employee takes advantage of what we offer. we’re committed to making it as easy as possible for our people to improve their health and maintain a healthy lifestyle. nevertheless, sometimes employees have medical conditions that remind us why good health insurance is so important.

fm: i was surprised that the average age of your employees is 39. i would’ve pegged the average much lower.

jf: we have very low turnover.

we have no real problems with chronic conditions right now. as we get older, this will be more of a focus.

fm: clif bar has five aspirations, and they all relate to sustainability, from sustainability of the planet to sustainability of your brands, with your community, people and business in between. tell me how wellness fits in.

jf: other companies offer great benefits to attract talent. for us, there’d be something missing if we didn’t do this. it’s one of our bottom lines. and it’s great that one of our aspirations is sustaining our people. but the fact that we want to give back to our community and sustain our planet? this, too, contributes to our employees’ well-being.

fm: so, is health data a driver at all?

jf: not really. we’re not big enough for it to be useful. and at our size, one sick person can dramatically affect our costs. plus, it won’t tell me about our employees’ psychological well-being, either.

there are different ways to approach our benefits plan, and we’re looking at those as a way to offer our people flexible coverage. instead of focusing on how we can reduce insurance costs, we focus on helping all our people stay healthier.

fm: if health care cost containment isn’t driving design, what is?

jf: different things at different times. gary and kit, clif bar’s co-owners and co-CEOs, are athletes. they care deeply about health, so that makes having a gym a no-brainer. many other things we offer—like bringing your dog to work or our sabbatical program—are based on what our people value.

there’s an appreciation for soaking up everything life has to offer. we ask ourselves, “how do we create that?”

fm: how do you create that?

jf: i think everything that happens is wellness. projects employees get to work on. relationships with the boss. are employees laughing at work?

now the things i have purview over are more traditional: a gym, nutritional counseling, our sustainability benefits program. when i’ve sat down with our wellness team, we’ve tried to create space to get out of the old paradigm. it’s so easy to create goals around BMI and not around social connections—what we know works but we don’t really know how to leverage. i have people here who if they know they have to make goals around health, it kills the fun for them. it strips all the joy out of it.

fm: you offer incentives, too. in fact, your incentives are a lot more than the current average of $460. an employee can get $500 to help cover the cost of a bike. they can get up to $960 a year in rewards for commuting by anything but car. you offer free onsite workouts with a personal trainer. a top-notch kitchen with subsidized meals.

jf: the easier, the more accessible, the more employees will take it up.

fm: how do you approach communications with employees?

jf: we’re still small enough that communicating isn’t a challenge. there are 190 of our employees in our headquarters, and we have an all-company meeting every thursday. we use online and email for everyone—and for our remote employees, in particular. our remote workers can also take advantage of many of our wellness offerings, such as life coaching and nutritional counseling, via phone and email. we also try to pull in family members whenever we can for events and to encourage employees to use wellness offerings to benefit their entire family.

fm: i’m sure you get asked this all the time: how can a company that doesn’t share your mission emulate what you’re doing here?

jf: what we’re doing here is very unique to clif bar and our mission. it could fail miserably elsewhere. we didn’t start with all of this, either.

i tell people to be an observer of your culture. what would help your employees most? think globally, not just the traditional things. what can you change about your culture that’d have a huge impact on employees’ health?

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my friend and co-health founder greg matthews introduced me to chris hall, director, clinical platforms at healthcentral. chris is intent on suicide prevention, and he’s working toward that goal through a mood-tracking tool, mood 24/7. i asked chris to walk me through how the tool works and what it offers individuals and employers.

fm: chris, what’s healthcentral?

ch: healthcentral empowers people to improve and take control of their health and well-being through more than 35 condition- and wellness-specific interactive health sites. what makes healthcentral different from other health sites is our focus on people living with and caring for those with life-changing conditions. our users have “been there” and have a deeper level of understanding for people with long-term health conditions. our users talk with and support one another, while connecting about their health conditions.

fm: now, what’s mood 24/7?

ch: mood 24/7 was developed by healthcentral based on technology licensed exclusively from johns hopkins university.

it’s an SMS- and web-based service that allows people to track their daily moods by text message. users pick a time of day and are prompted via text message for a text message response rating their mood on a scale of 1 to 10. these daily responses are charted privately and securely at the mood 24/7 website, www.mood247.com, where users can access their mood charts to visualize mood triggers and track their mood.

fm: what kind of action does someone take based on the info they see?

ch: that’s where it gets interesting. i recently interviewed a few power users, and they all said that mood 24/7 has helped them get to know themselves and their conditions better as a result. what i discovered from talking with these people was that we don’t always know the triggers behind our mood fluctuations. daily mood tracking serves as a starting point for that understanding. we’ve also established a sharing capability, where mood 24/7 users can opt to allow members of their trusted circle—friends, family, doctors—to see their mood charts as well. all they need to know is the email address of the person they’d like to share their chart with and we do the rest.

fm: since you’re providing information at one period of time, how does this help me isolate what makes me happy or unhappy? whether i’m happier at work or at home? or what are my triggers?

ch: that’s a question that comes up a lot, and being somewhat of a data nerd myself, i do understand the desire for more data. however, the beauty of averaging your mood once per day is that it forces you to reflect on the day’s events in aggregate and come up with a number for how you felt in general. one event could have ruined your entire day, and taking the time to make that internal calculation lends itself to discovery. mood 24/7 also allows for journaling via text message, so users can take notes while submitting their daily mood to help them further identify mood triggers and patterns from the website. we think this process makes it easy for people to add mood 24/7 to their daily routines, while also adding a great deal of value to their lives.

fm: is self-reporting accurate?

ch: we think so. in general, there doesn’t seem to be much incentive for people to lie about how they’re feeling among their trusted circle. in fact, dr. adam kaplin, mood 24/7’s inventor, relayed a story to me of a patient he hospitalized because he was able to identify in the mood chart that the individual was suicidal. dr. kaplin later asked the patient why he even bothered to update mood 24/7 while seriously contemplating suicide, and the response was that it was part of a daily routine. the patient had woken up that day, brushed his teeth, combed his hair and got dressed like any other day… and when the mood 24/7 text came in, it was answered honestly without hesitation. it had become routine.

fm: that’s interesting, especially when you consider bj fogg’s work with stanford’s persuasion lab. he suggests that any new routine be latched onto an existing routine. that way it becomes more readily habituated.

ge healthymagination just came out with their mood app, moody me. then there’s intel’s mobile therapy and the military’s t2 mood tracker. these use smartphones and other technologies. why are you using SMS?

ch: we’re high on SMS because 91% of americans have a cell phone capable of texting according to the CTIA, and we’re focused on helping as many people as possible. we also know that every age demographic knows how to send and receive text messages. we’ll definitely be looking to open up the ways people can provide their daily mood ratings in the future, but based on its near ubiquity, we felt that SMS was the best place to start.

fm: what evidence do you have that mood 24/7 works?

ch: right now we have two unpublished studies and a lot of anecdotal evidence that mood 24/7 works, but i’m working very hard to get more proof. many of dr. kaplin’s patients used mood 24/7 in 2010, and we’re in the process of getting approval to study that data for outcomes.

fm: are any employee assistance programs (EAPs) or insurers using this as part of their mental health benefits?

ch: not yet, but we have some things in development that we should be able to talk about in the near future. plenty of studies have been conducted around stress and depression in the workplace, and we feel that mood 24/7 can add a lot of value to employee wellness benefits.

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read more free-ranging interviews with health innovators.

pitney bowes is well regarded as an innovator in employee health, thanks in no small part to their former CEO mike critelli’s vision and dedication. i spoke with dr. j. brent pawlecki, corporate medical director at pitney bowes, to find out what they’ve learned through the years.

fm: pitney bowes started thinking about their employees’ health well before most companies. why was that?

bp: mike critelli, the former CEO of pitney bowes, had been the VP HR for the company. he understood the importance of keeping healthy.

fm: where did you begin?

bp: we looked at our health data and the high cost drivers that were affecting our productivity. then we started with low-level programs at headquarters: flu shot programs, well-being programs. things that helped begin health education.

at that time, people believed information would help change behavior; a lot of people still believe that. we’ve evolved our thinking. information is no longer sufficient. one of the issues that’s missing is the emotional triggers. for example, if i have a broken arm, i can’t pick up my three-year-old. or, when you think about someone’s relationship with food, we typically only hear calories in, calories out. that’s true, but everyone has a relationship with food. when i was eight, i tried on a pair of pants i’d received, and they were too small. my family threatened to put me in “husky” pants. i decided right then i’d never be fat, and that has shaped every piece of food i’ve ever eaten.

fm: my relationship with food comes from a different place, but i know exactly what you mean. our histories drive our present-day behaviors and attitudes.

bp: we developed an internal blog about one year ago. on it we share both health information and personal stories, and we bring in guest bloggers. my second guest blogger was a victim of domestic violence. you don’t always know people’s personal histories. i’m totally amazed that people are able to get through their day.

fm: that’s so true. we keep a lot hidden—more so at work than anywhere else, partly out of necessity, right? how do you handle this especially complicated marriage of health, work and influencing employees’ behaviors?

bp: it really helps that we’re a trusted brand. there’s a trust here that goes way back to prior CEOs’ actions. for example, pre-racial integration, one of our former CEOs refused to stay at a hotel because a colleague couldn’t.

we also maintain a very strong privacy rating in our clinics and in our business. if i run into an employee in the hall, i’ll never bring up their medical issues. now, people will stop me in the cafeteria to ask a question. they don’t always think of what it means to maintain their privacy. if that happens, i’ll pull them into a more private setting to discuss their health issue.

fm: what forms the core of your program today?

bp: there are things that should be the core of any program, focusing on: 0% tobacco use, daily flossing, 25 BMI, 5 fruits and veggies and 30 minutes of exercise per day, and 100% seatbelt and helmet use.

we frequently have built-up silos around health: mental health, disability, health and welfare. we try to break down these silos. if someone comes in with a cold, we’ll find out their kid’s been diagnosed with a condition. we talk about that condition and how it’s affecting them, and then we direct them to the appropriate resources, helping them navigate the often-confusing medical system. we’ve added end-of-life planning. we talk about domestic violence and substance abuse so employees know there are resources out there for them. wellness programs should be hitting on these. it’s not just weight and fitness.

fm: do you use incentives or penalties at all?

bp: initially our incentives were directing people to complete a health assessment. to have employees understand key health information, we incented people to complete health education modules, like “knowing your biometric numbers,” “how to use the health system” or “understanding various health conditions.” we’re now incenting people to participate in specific health programs through their health plans. whenever possible, we believe that the “carrot” approach is the appropriate way to motivate individuals.

fm: i know that you’ve also considered how design influences behavior.

bp: in our cafeteria, the healthy options are the visible, cheaper choices. our default side is carrots, not chips. steelcase produces something called a walkstation. we purchased them for our call center folks. we also have them at other locations, and anyone can use them. i can plug in my computer and work. when we redesigned our world headquarters, we removed individual printers. people have to get up. they have to interact. and, by the way, it also saves on paper. we also built our stairwells right in the center of things. they’re very airy, and they go right into our central area where there are things like the ATM. i think that people mostly want to do the right thing, but they forget. whenever possible, we build our default to be the better choice.

fm: how else are you reaching your employees?

bp: one-half of our population doesn’t have computer access. they’re the folks who aren’t using health care well, either. every day our non-wired employees have a huddle calendar, and we insert health messaging in these. we put together project: living, which consists of a newsletter, personal stories and home mailers. our next step is to use a computer platform that’ll be accessible to families, providing them the health information that our employees have had access to through our programs. we want to include family members, who are 44% of our health care costs.

fm: one thing i’m very keen on is getting more employers to agitate the system, something that pitney bowes seems to be doing.

bp: we believe that by improving our community, we’ll make things better for everyone and for our future employees. we participate at many different levels, programs and coalitions. i’m active at national and global levels for benchmarking what’s working. our CEO was at the white house to talk about health care reform. we met with the health commissioner, the CDC. we sit on boards: domestic violence, public health organizations and large regional players. there’s a lot of activity to improve health and health care beyond our walls.

fm: since you’ve been at this a long time, you’ve obviously been able to track results against your baseline. can you tell us what’s been effective and what kind of results you’re getting?

bp: a lot of people ask us what is our ROI on an individual program. we believe there’s a better response, as each of the programs is a tool that contributes to our ultimate ROI: the health of our employees and our overall health care costs, which for us have been trending at roughly two-thirds the cost of our benchmark companies.

fm: recent surveys show employers becoming much more focused on tying incentives to individual results, like a lowered BMI, not just participation. what’s your point of view on this?

bp: currently, our approach is to encourage participation. one’s never completely finished in building a culture of health. this is a lifelong marathon that can be encouraged and supported by an understanding, supportive and progressive workplace.

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read more free-ranging interviews with wellness innovators.

fred muench is a clinical psychologist and the founder of mobile health interventions, a company dedicated to using technology to improve mental health. he consults on research projects at the national center on addiction and substance abuse at columbia university. he’s put all of his knowledge to practical use with health txts and in the irreverent “official guide to dysfunctional parenting.” i reviewed health txts a while back. (not the book. i need no help in this department. i’m just blessed.) since then, fred and i caught up by phone to talk about what he learned from the beta test and how text messaging can support desired behavior change.

fran: what’s the idea behind health txts?

fred: health txts was borne out of my background and experience as a psychologist researching mechanisms of change with addictive behaviors. when people are in treatment, they have no craving. but in their natural environment, that craving comes back full force because of all the triggers and memories associated with use. with health txts, we wanted to create a very simple program that’s a reminder of your goals when you’re in your natural environment.

fran: there’s so much focus on health apps for smartphones, yet more people actually own simple mobile phones. is that why health txts uses SMS?

fred: there’s a lot of excitement about new health apps using smartphones—and rightly so. they present an amazing opportunity. however, it seems like everyone’s so focused on the technology as a means to an end that we forget about the process of designing an actual intervention. having GPS on a phone doesn’t mean anything unless you can inspire behavior change using that technology.

SMS is simple and powerful, and we have some understanding of why it probably works: getting a message in your natural environment makes a goal more salient. but this is just the foundation. there’s so much more we can learn to make SMS significantly more powerful—like what type of message is helpful for which type of person at what moment. i think it’s a mistake to dismiss SMS as antiquated when we haven’t done enough research to maximize its potential.

fran: health txts was in beta when we was last spoke. what did you learn?

fred: with health txts, we offer people a number of different message choices, from general motivation to healthy eating to messages on gratitude. we offer the option of getting prewritten, expert texts or of writing your own. our beta users’ top three goals were motivation, exercise and healthy eating.

we found that people really wanted the expert messages; however, in our survey the majority of people said that the messages they wrote themselves were the most helpful. this was interesting because the research we’re doing is attempting to understand how self-modeling and self-written messages increase goal-directed behavior. we also learned that people appear to prefer motivational and action messages to informational messages.

what surprised me the most was that messages designed to help people exercise seemed least helpful. people tend to plan exercise in advance, so getting a message saying “go to the gym” just didn’t really work for people. they needed to have their gym clothes. the messages that people reported were most helpful were the ones that inspired a cognitive shift, like gratitude. people also reported the healthy eating messages were helpful. we’re trying to understand what types of messages work for what types of goals and, more importantly, what types of people.

fran: now that you’re through beta, what’s next?

fred: we have a grant through the national institute of drug abuse (NIDA) to create an interactive messaging system. users will fill out an assessment, and we’ll send them customized messages based on their assessment. the goal is to tailor the expert messages to each individual while also encouraging them to write their own messages. there are others doing similar types of programs with other goals. for example, kevin patrick has created a similar program for weight management. what’s most exciting in the field is ecological momentary assessment, which is follow-up assessment and tailored feedback on the mobile phone over time.

fran: how does this work?

fred: let’s say you were screening employees for burnout. you could create a message: on a scale from 1 to 5, how burnt out do you feel about work? based on what the employee responds, they’d get a tailored reply. with a rating by the employee of 1 or 2, the text might say: “glad to hear you’re not feeling burnt out. if you start to feel overwhelmed, we’re here for you—x243.” whereas with a 4 or 5, it might be: “life can seem overwhelming now. please seek support ASAP at x243. it’s confidential and can really help you improve your life.” the key is to have numerous messages for each response so it doesn’t get repetitive. the intervention possibilities for such systems are endless. however, supportive messaging could just be a simple expansion of an EAP program.

fran: i used health txts as an individual. i didn’t realize you’re also offering this service to companies.

fred: definitely. we have several companies using it for their employees. we have an open access professional program where EAPs or clinicians or whoever can create their own expert message program for their clients or employees. once they create the messaging program, which can include assessment items, employees sign up. alternatively, employees can receive supportive messages (for nearly any goal) using our existing system. interestingly, what we’ve found is that like with individuals, companies prefer off-the-shelf solutions.

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• more on health txts here and here
• more free-ranging interviews