Most of the information and guidance we receive related to our health goes in the “one size fits all” category. Get more than 30 minutes of moderate exercise five times a week. Eat less than 3,000 calories a day. While these general guidelines can be helpful, we all have unique characteristics – both in our personalities and our genetics – that would be better served with personalized support.
Aetna recently found positive results with a pilot program using this type of targeted approach. Aetna Innovation Labs worked with Newtopia, a personalized health company that used a combination of behavioral science and limited genetic testing to build a highly personalized disease prevention and weight management program for Aetna employees at high risk for metabolic syndrome. Over the course of the year-long program, the study found that:
- Approximately three quarters of the more than 400 people in the program reported significant weight loss, with an average weight loss of 10 pounds.
- People in the program improved in several of the risk factors associated with metabolic syndrome, including waist size, triglycerides and “good” cholesterol (HDL) levels.
- Average health care costs were reduced $122 per program participant per month.
Results of the study were published in the September 25 edition of the Journal of Occupational and Environmental Medicine.
Old school versus new school thinking
The pilot program was designed to be both highly personalized and “high touch.” Employees were provided personal coaches and client care managers to achieve high levels of engagement and sustain behavioral changes, with consistent interaction between health coaches and the participants. The people in the program could reach out to their coaches by Skype, phone or e-mail. More than 50 percent of those enrolled remained engaged for 12 months, a significant improvement over the industry average.
Participants also had a mobile app and a personalized website that was tailored to their specific goals and allowed them to enter information related to their physical activity, behavior management and nutrition.
Targeted genetic testing added an innovative element to each personalized health plan. While there are more than 50 genes involved with obesity, the program focused on identifying three specific genes with connections to obesity, appetite and compulsive behavior. People in the program voluntarily provided saliva samples for this test, which were then analyzed by the Newtopia team. (For privacy reasons, Aetna never had access to the genetic tests of the participants).
The results of the genetic test in conjunction with a personality profile were used to help create a personalized nutrition, activity and behavior management plan, and to pair people up with a health coach.
The results of the genetic test, in conjunction with a personality profile, were used to help create a personalized nutrition, activity and behavior management plan, and also identify the best health coach for the participant based on a proprietary personality-matching algorithm. The results of the genetic test were also shared with the program participants, with some participants describing increased levels of engagement as the result.
Pilot success leads to widespread availability
Based on the success of this pilot program, Aetna is now offering the Newtopia program to its largest customers and their employees. We are also evaluating how this type of personalized, targeted approach could be applied to helping people with other health conditions.
We are already used to receiving personalized recommendations in our everyday life, such as things we buy online and movies and television shows that we watch. While our activities as consumers can have importance, our health is our greatest asset. We should expect and demand a similar type of personalized approach – with personalized wellness programs that are aimed at improving our individual health. This can be achieved by appropriately combining clinical science and technology to create individualized programs that truly make a difference.
“Understanding my genetic results helps a lot. I have variation in two genes: the Appetite gene and the Fat gene. The Appetite gene may cause me to overeat as my brain is slow to tell me when I am full, and the Fat gene may prevent fat from being broken down in my body in an efficient way. My Newtopia coach gave me techniques to overcome these issues. To help break down fat more efficiently, I now walk every day or ride my stationary bike. I’ve learned to eat more mindfully. If I am still hungry I usually take a break before opting for a second helping. This gives my brain an opportunity to catch up to how my stomach is feeling.”
Therisa Hilt, medical claim analyst at Aetna
“I tested negative for these genes, but it actually helped my mindset for the program. Knowing that I didn’t have those genes meant I had more control over improving my health than I thought in the past. It also meant that I no longer had any excuses for being overweight. My coach has been and still is very supportive and understanding when it comes to those life obstacles. She has taught me that it’s OK to indulge during that ‘once in a lifetime vacation.’ You just have to make sure you don’t give up or guilt yourself into giving up afterwards. It’s all about finding a new comfort zone, one that includes better eating habits and exercise that fits you.”
Aetna Innovation Labs
Aetna Innovation Labs is a source for unique ideas and programs that provide market-leading capabilities to improve health care quality and reduce costs for our customers and members. Through this organization, Aetna can test specific initiatives such as those related to disease prediction and intervention; rapidly determine success rates and impact across populations of members; and quickly expand programs that show promise.