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Royle Berry: Connected Wellness Community

September 7, 2011 Leave a comment

HCD – Healthy Community Development has attracted many highly skilled and dedicated individuals joining the ranks of our Member Consultants. You can read about many of them here (search to the lower half of the page). One of our most recent additions to the expert Consultant group is Royle Berry.  You can follow Royle on Twitter (@wrnbr), on Facebook and LinkedIN.

Royle’s passionate belief in the positive effects of regular physical activity have been a driving force behind his tireless efforts while developing the Wellness Resource Network in Baton Rouge. The value of his decades of carefully honed business and sales experience only enhances his underlying commitment to delivering positive returns to both the fitness destinations, the local community and the individual participants.

Take a few moments to explore the Wellness Resource Network in Baton Rouge, LA.

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Are we too connected?

July 16, 2011 Leave a comment

Today I did an experiment. I had gotten up early to go on a 42 mile bike ride with a local group, but it was raining. Skinny tires, rain = me sliding too much. I decided to update my various social networks around wellness and my mobile apps while waiting for the roads to dry a bit.

Two hours later I am frustrated and perplexed. How can all of the creativity, innovation, understanding of behavior and psychology around habits, change and wellness have produced a quagmire or inputting, updating and connection efforts – but very little motivation.

I can hardly wait for the roads to dry so I can join my friends on a long, scenic bike ride and none of them are “friends” on any of my so-called social connection wellness tools.  here’s the run-down of what I did this morning:

Logged in to Nike+ and found my last logged run was June 8. I have two friends, no challenges and 5 trophies. Do I care, since I am not training for a run? Somehow I had neglected to upload from my iPod sensor for awhile. Did it (12 minutes). Downloaded the app for my iPhone so I don’t have to do that any more.

Logged in to MapMyRide and saw everything was up to date. 209 miles over 13 rides and very cool elevation detail. I don’t have any friends on this app either but I like it. I thought it updated to MapMyRun and NIke+, need to learn how to connect it all.

On to Daily BurnDaily Mile, MeYouHealth and Daily Challenge. It was fun to see how some friends are succeeding in training for events. Did a status update on each (14 minutes)

I quickly walked up and down my stairs in order to get my next landmark (Tower of Pisa) for 300 steps, but I usually walk 2-5 miles 3-4 times a week but simply forget to turn on the Monumental app. Maybe if I walked the stairs at work this app would be much more cool and social for me. (9 minutes)

I went outside to try the NIke+GPS app I already had on my phone but I had never activated it.  The app has a cool game of tag. I only have 2 Nike+ friends so I invited them both to play TAG. I did a quick run just to be in the game. (15 minutes)

As long as I had my phone out I did a quick walk with the Arookoo app. It has a Facebook game connected to it (boring tasks and slow loading) that I don’t quite see the connection to real walking with. I earned some energy but it’s not so important in the online game. (8 minutes)

I also have Hidden Park so I checked to see if anyone in town had done my Hidden Park activity I created a few months ago (45 minutes) but no one had. Too bad.

I have GPS Mission on my phone, so I decided to activate it and give it a try – registration log in stalled out so I deleted that app. Also got rid of a non-social pedometer, really what did I need that for? (7 minutes)

I swung through Skimble and did a few ab exercises, then remembered that I could do that with my EA Sports Active and WiiFIT. Whew, 47 minutes later I am back at the computer. Good workout! (and it looks like the rain is done and roads are drying up). Before heading out on my bike ride I quickly checked in at StickK to update my status (3 minutes) – my referee on that site hasn’t cheered me on for a while, I have been letting her down as well. Too busy?

Since there are more than 17,000 mobile health apps for smartphones, I think the best innovation is going to be where we have ONE log in that connects our friends, our activity, our community and “game points/levels/badges/trophies” all in one. I find that my smart phone and its handy arm band holder and instant uploading to the websites is my preferred physical activity tracking method.  I resist sharing on Facebook, every “friend” on Facebook doesn’t need to (or care to) witness dozens of updates from dozens of apps all over their Facebook. Yet without that sharing, what connection/social graph support am I missing?

I would love to hear your comments on this.

Exercise Carrot? Play on the Team?

June 28, 2011 Leave a comment

Why won’t the very individuals that need the data, logging and exercise participation tools developed by creative and dedicated companies actually use them?  That is a problem that we all grapple with and we succeed at varying levels not always in balance with time and money invested in the process. The recent end to Google’s  Health Records Service seems a good time to address the basic premises behind a lot of hard work and innovative technologies.

What’s the problem?  I wish I knew.  In my experience over the past 15 years with people of all ages in a wide and diverse set of environments one thing seems to be a factor: People are too busy with other things – there is an information overload even for those who might be motivated to begin a tracking or logging habit around diet or exercise.

That behavior change is a tough sell to the individual, because the “individual” is never the specific target.  Behavioral inertia is a function of our choices and habits – both the good ones and the bad ones. Selling directly to the individual consumer might work for the “sale” but not for the long term compliance to use the product – whether it is a gym membership, a fitness dvd, new jogging shoes etc. In the longterm, the individual is pushed toward daily choices by their sense of having power, choice or control over their actions – at any age.  If work, family and other things are limiting, stressful and overwhelming they will head to something they have control over for their leisure, social, entertainment and “off-time” choices. Exercise and wellness pursuits requiring discipline or change don’t usually make the top of the list.

Competence is another basic human need and when an individual is not competent at sports, exercise and being active (because of choices – see above) they don’t choose that. Edward Deci and Richard Ryan can provide rich insights at their research PDF website. 
Do we have a key to behavior change? Relatedness, or an individual’s need to feel connected socially or to a group is a powerful tool.  This is also related to a person feeling valued by things outside his or her self.
The way to get it right? Allow an individual to feel connected to others socially, to feel related and to function effectively among their social network and to feel a personal initiative in doing so.  Well, that’s easier said than done!
The key could very well be the process of identifying the “personal initiative” that resonates with various social networks of collective individuals. If we want to manifest motivation and sustain engagement with even the best PROGRAM we need to discover a process that attends to all of these needs. This puzzle has been explored by the best, maybe the research we are all most familiar with is via the book, CONNECTED (Christakis, Fowler) and related articles.
What if a person feels motivated (by self, an employer, a physician) but is still unable to overcome behavioral inertia? The most common response is to create a system of “motivation” and reward. Oops, there rises the danger of the extrinsic reward undermining intrinsic motivation, which is exactly the motivation we want to encourage. In a 2010 paper by Elbrys, “Designing Behavioral Change Programs to Initiate and Sustain Engagement,” they propose what I believe is a very valid description for reward. “Rewards should maximize the recipient’s sense of autonomy and competence.”
In the late 1980″s I wrote a manual for Wilson (the tennis ball company) called, ‘The Game is Life.” It was based upon the power of play and how/why we could emulate exactly what children do while at play for our own enjoyment of game, sport and activity.  Perhaps in our laser-focused quest to “reduce the obesity crisis” via exercise we have squeezed every ounce of play out of the endeavor.  How many of our target populations feel a relatedness or sense of belonging to the tribes, crowds and social networks happily playing at physical activity, sport and fitness pursuits?  If we create a sense of team, relatedness and belonging for our “least active,” will they make the choice to “play the game” for a longer time period? Can we guide long term engagement by creating play opportunity first and motivation/rewards as a second tier bonus?

Free from Medicare: Got Physical Activity?

June 25, 2011 Leave a comment

How often have we heard that prevention of the most expensive and chronic conditions is the best way to manage and reduce healthcare costs. Research has demonstrated again and again that physical activity participation (ACSM guidelines) power prevention. That is the cornerstone of the HCD Wellness Resource Network processes and solutions.

To save lives — and money — lost to preventable diseases, the Affordable Care Act offers all Medicare beneficiaries a wide range of preventive services. These services are free with no co-pay involved.

Look at the list below and note the absence of any physical activity program or PA counseling in the mix. Yes, these tests are important – but so is habit change and the development of an Active Wellness Engagement (AWE) lifestyle.

Services now free to most Medicare beneficiaries include:

  • A one-time “welcome to Medicare” preventive visit
  • A yearly wellness visit
  • Screening for heart disease
  • Breast cancer screening (mammograms)
  • Cervical and vaginal cancer screening
  • Prostate cancer screening
  • Flu, pneumococcal, and hepatitis B vaccines
  • Osteoporosis screening
  • Smoking cessation counseling
  • HIV screening
  • Diabetes screening
  • Medical nutrition counseling for people with diabetes or kidney disease

Healthy People 2020 – What’s In the Social Network?

May 16, 2011 Leave a comment

Recently, Healthy People 2020 joined with the President’s Council on Physical Fitness to brainstorm and collaborate around ways to reduce the cost-impact from obesity related conditions.  They determined a few “truths,” but I sincerely believe they missed one of the most important factors.

Granted, a person’s physical activity levels are not determined by will power alone. They are also influenced by a number of social and environmental factors including:

  • The built environment, such as the availability of sidewalks, bike lanes, and parks, as well as physical barriers, such as lack of accessible facilities for people with disabilities
  • The natural environment, such as weather and daylight hours
  • Policymaking, which can improve or reduce access to facilities that support physical activity
  • Social factors, such as the cost of physical activities, social norms, neighborhood crime, and social support
Looking closely at the final item in their list we finally see what might be the most crucial and important, they call it social norms and social support.  I believe the group is thinking about the importance of what a group expects of each other and the social group support (or lack of it) around physical activity.  Close, but not a bulls-eye.
No bull’s-eye either for the new Healthy People 2020 objectives related to policies targeting younger children through:

  • Physical activity in childcare settings
  • Television viewing and computer usage
  • Recess and physical education in the Nation’s public and private elementary schools
The one thing most important is missing – what do families and friends already do together and in their spare time? Are they active? Is physical activity given prime time in their schedules, dates, social activities, hobbies and leisure activities?  If those lifestyle choices are sedentary – an individual will be hard-pressed to move the entire group-habit no matter how motivated one individual might be.  Until options, choices and PA programs intertwine with existing activity and leisure choices we will always have an uphill battle among the least active – and most at-risk.
When a lunch outing with friends or a shop[ping trip can include motivating, easy-entry, physical activity fun for the ;east active social networks we’ll be one step closer to longer term engagement. When a drop by a favorite pub or coffee house can include a physical activity piece in a seamless and relevant manner – we will be on the right track.  Mobile apps, branded incentive programs and group synchronous and asynchronous game options are a technology poised to create activity-life-choices an ACTION item.

MAY 2011, EXERCISE IS MEDICINE MONTH

April 29, 2011 Leave a comment
Thanks to a recent news release by Ashley Crockett-Lohr (alohr@acsm.org) and
Dan Henkel (dhenkel@acsm.org) we are now aware that May 2011 is,
"EXERCISE IS MEDICINE MONTH."
In an e-mailed press release I tried to find online, but couldn't,
the reporters had an important message.  
Instead of summarizing, I would like to produce the entire
press release here. If any readers do locate the link to the original
release I will be happy to post it.
This is a particularly important topic for HCD.  We are working
closely with ACSM and EIM to develop a Physical Activity
Intervention Program "menu of options" that meet a certain review
and approval from the ACSM. Often, healthcare providers need to
more about which PAIPs are best for their patients. 
"Public encouraged to get active, health care professionals asked
to prescribe exercise"
INDIANAPOLIS – The fourth annual Exercise is Medicine® Month kicks off on
Sunday, celebrating the health benefits of exercise and offering resources
to get people moving.
“Everyone should start or renew an exercise program now as an investment in
life-long health,” said Robert E. Sallis, M.D., FACSM, chair of
Exercise is Medicine.
“Every person, regardless of age or health, is responsible
for his or her own physical activity. There are far more reasons to
exercise than excuses not to.”
Exercise Lowers Health Care Costs
Research shows that exercise helps treat and prevent more
than 40 chronic diseases,
such as diabetes, heart disease, obesity and hypertension.
“While there are numerous reasons for soaring health care costs, one undeniable
explanation is the poor physical health of so many Americans,” said Sallis.
“Exercise is something every person can do to control the rising costs of
health care and improve quality of life.”
Health Care Provider Involvement is Key
Most health care providers don’t realize the effect they have in motivating patients.
Nearly 65 percent of patients say  they would be more interested in exercising if advised
by their doctor and given additional resources.
“Health care providers, including physicians, should assess physical activity at every
appointment, write exercise prescriptions and be prepared to refer
patients to fitness professionals,”
said Sallis. “Every doctor should be an exercise advocate.”
A Two-Way Street
Starting a physical activity program can be as simple as taking a
brisk walk each day andgradually building up frequency and duration.
Patients are encouraged to talk to their health care provider
for an exercise prescription if additional advice and guidance are needed.
Easy-to-Use Tools Available
Most people already know exercise is important. Many are overwhelmed by where
and how to start, particularly those new to exercise, those
who have an existing health condition and the elderly. Simple, easy-to-use
exercise tips, tools and videos are available online to help them get started
and stay motivated.
Partners Spread the Exercise Message
Exercise is Medicine partners include the American College of Nurse Practitioners,
the American Academy of Physical Medicine and
Rehabilitation, the American Medical Society for Sports Medicine and
organizations and universities from all parts of the world.
Governors and mayors nationwide have already signed on to
proclaim May 2011 as Exercise is Medicine Month in their communities.

Wellness Gamification

April 20, 2011 2 comments

Every successful business person learns this – often the hard way: Distribution is king!  Enter a big-box store, see the huge display, try the game.  We all do it. We don’t really know if we will like the game until we play – but we make a purchase.  Same with the movies – huge distribution equals many eyes, many tickets sold.

Nobody sets out to build a bad game the same way that nobody sets out to make a bad movie. But we’ve all seen too many bad movies. The extraordinary “sleeper” game or movie is always refreshing – and for those, distribution comes second, if at all.  That is the exception to the rule.  In our dedicated attempts to create a wellness culture, to get the 80% of the population that is least active to “start playing the wellness game,”  we work very hard. We try to connect with the influential “hubs” in a social network. We try to understand and implement the best that social networks, gamification and viral-sharing can deliver for wellness programing.  Are we headed in the right direction?

I will be part of a panel at Games for Health (Boston, May 17-19) with great leaders – Jenn Mercurio (Entertainment Consumers Assoc/Gamers for Health), Dr. Ernie Medina (MedPLay and National Active Gaming League) and Dr. Lisa Hansen (University of S. Florida and exergame pioneering expert).  Add up the revenues and there is no doubt that on a commercial level, for major videogame publishers, there has been a lot of success for exergaming. (Got Distribution – YES!)  Just factor in some of the success for entire platforms like Wii, Sony Move!, and Kinect and it’s clear that active or movement gaming is a success.  But is it a health success? Has it delivered momentum toward a wellness culture?

On one level, it certainly has, a series of small studies has shown, under the right conditions and situations, exergaming and active gaming offers a new tool to combat inactivity, deliver aerobic exercise, and related wellness/fitness factors.  However, the scale of success and impact in health pales in comparison to the sales success for those “games” with huge distribution.  This is a pattern that exists in other areas too including gym memberships, exercise equipment sales, etc.  But does it have to remain this way for active videogames/exergames?
We hope the discussion started at this session with continue over time and across distances. The subject is both complex and powerful.

The popular new buzz-word around all sort of customer/client behavior change is “gamification.”  Do a Google and Wikipedia search if you need some background information on that word. Gamification is a little bit a part of life. Isn’t everything a game? Isn’t everything a negotiation? Games are part of the fabric of human habits and choice. Some game mechanics go into fashion and out of fashion. But fundamentally, it is just about the psychology of a person and drawing them into an activity.  That is where we hope to make a powerful impact on the physical activity habits of the 80% least active in a population or community.  Wellness gamification – talk about design challenges.  More than game – it’s a life choice and health dilemma too expensive on so many levels to ignore.

Opportunity exists in this space like never before. Even non-gamers are touched by “social gaming” and mobile apps on a daily basis.   Social and mobile right now are part of the functionality of everything we experience. That easy access to huge groups of people could easily provide an entry point for doing wellness gamification badly. It would never be done badly by design – but perhaps by lack of understanding the deep motivators for wellness behavior among those who need wellness change the most.  If it were not so complex it would not become the cost-monster driving healthcare and national economy into financial ruin.

People like to play games and so gamification helps people to do the things they like doing more. An app that gamifies shopping is going to be wildly popular among people who really like to shop. So adding gamification to that activity-choice helps them to do more of the things that they really like to do. What gamification has not ever been successful at is getting people to do the things that they don’t like to do. I should eat less and work out more. I don’t like to eat less and I don’t like to work out more. And putting a score board against it is actually not going to get me to do even those things.

Our quest, our dream:  To create a game/gamification that rewards the behaviors that our least active populations already love to do, choose to do and do with friends and family – then connect those behaviors to relevant  physical activity participation. Of course,  there are limits to the gamification. It just becomes good program/product management for the things that a population likes to do. But it also has its limitations.  The pioneers in wellness gamification must acknowledge that. Understanding where those limitations are is really important.  Equally important is knowing the deeply rooted behaviors and choices of our target populations.  Aligning the challenge and solution design is neither obvious or easy.  The winners in the wellness gamification space will get it wrong – often – but can eventually get it right.

Tell us what you do. Hammer us with comments, questions, discussion threads and links to your blogs, your ideas and your insights.