Well-Being and Health Care Use

A study reported in the journal Population Health Managment involved a randomized trial to ascertain whether wellness programs contribute to improvement in multiple domains of an individual’s sense of well-being.   (PHM Article)   In particular the study focused on whether interventions could affect risky health behavior and whether changes in behavior would promote better well-being.  The interventions were based on the Transtheoretical Model and addressed stress management and exercise.  There were three groups in the trial; one was an intervention through telephonic coaching with exercise as the primary target and stress management a secondary one; one was an online coaching intervention with stress management as the primary target and exercise secondary and a control group which was assessed but received none of the program.   The primary outcomes were the effect on four well-being domains:  healthy behaviors, physical health, emotional health and life evaluation.

Participants were recruited through the internet and had to be at risk in terms of their health or health behaviors.  Originally about 3400 persons were assigned across the three groups.  All had an initial assessment and one after six months.  The intervention groups basically had three interventions, one at enrollment, one after three months and one at six months.  Participants were incented for each step of the process, but not for outcomes.  The interventions were individually tailored according to the personality assessment.  Relatively standard survey instruments were used for the evaluations of outcomes.  Both the telephonic and online intervention groups showed greater progress in exercise and stress management than did the control group, and the telephonic intervention subjects did better than the online ones.  Both intervention groups also reduced their unhealthy behaviors more than the control group.  Both groups also showed greater improvement in both overall well-being and in individual domains.