HABIT DESIGN: TESTING A NOVEL BEHAVIORAL APPROACH TO CORPORATE WELLNESS IN THE CONTEXT OF METABOLIC SYNDROME

Abstract Metabolic syndromeMetSis a constellation of risk factorselevated triglyceridesTGinsufficient highdensity lipoprotein cholesterolHDL Celevated blood pressureBPelevated fasting blood glucoseFBGand above threshold waist circumferenceWCthat is associated with increased cardiovascular diseasetypediabetes mellitusand some forms of cancerResearch suggests that addressing MetS through the workplace could significantly benefit employee health and employer healthcare costsHabit DesignInchas developed an enhanced behavioral health coaching system called Habit DesignHDthat is the first to integrate habit formationcontingency managementand social learning approaches within a smartphone app to support to behavior change in corporate or employee health contextsIn this Fast Track projectwe will adapt the HD approach to address MetSIn Phase Iwe willrefine and extend existing functional prototypes of the HD app to support the latest versions of iOS and Androidconduct usability testing withtargeted end usersandprepare standard treatment manuals for the Phase II clinical trialIn Phase IIwe willmake indicated changes to the HD app based on findings from the Phase I usability test andevaluate the effectiveness of HD coaching compared to standard health coaching in a randomized trial withcorporate wellness program participants who have MetSwith follow up spanning one yearParticipants will employees of TriHealth in Cincinnati who have completed a health screening as part of their corporate wellness program and been identified as having at leastof the followingTGmg dLHDL C andltmg dL in males and andltmg dL in femalesBPmm HgFBGmg dlandWCcm in males andcm in femalesAll participants will be coached to increase physical activitywhich will be monitored with a waist worn FitBit and Fitabase softwareAdditionallyparticipants will choose prior to randomization a goal of increasing fruit and vegetable intake or substituting water for sugar sweetened beveragesConditions will be stratified by choice of goal and genderIn both conditions coaching will be monitored for fidelity and delivered inweekly in personminute sessions followed by oneminute maintenance session per month formonthsThe primary outcome will be average daily step count measured over the course of at least one week at baselinemonthsmonthsandmonthsThe secondary outcome will be standard units increase of fruit vegetable intake or water intakeaccording to the participantandapos s choiceTertiary outcomes will consist of FBGTGHDLBPWCand body mass indexmeasured at each time pointAdditionallywe will conduct web based assessment of self reported physical activityjunk foodand sugar sweetened beverage consumptionautomaticity of exercise and fruitvegetableand water consumptionself efficacy and social support for target behaviorsand health related quality of lifeRatings of usability and satisfaction and app usage metrics will be examinedAnalyses will be intent to treat assumingloss to follow up Project Narrative Relevance Metabolic syndrome is a major public health problem that affects over one in three American adults and increases the risk of cardiovascular diseasetypediabetesand some forms of cancerHabit DesignInchas developed an integrated health coaching system that uses a smartphone app to promote healthy behaviorsWe will adapt it for metabolic syndrome and evaluate its effectiveness in a corporate health setting