May 30, 2023

Persistent Engagement Is Key To Health Improvement


Well has an individualized approach to frequent health engagement, informed by our expertise in consumer marketing and behavioral science.

The average American spends more time on social media in one day — and more time on laundry in a week — than with their doctor in a year. That minimal commitment might be fine for a checkup visit, but is it enough time in the aggregate to get your blood pressure down or your exercise minutes up? Research shows, clearly, it isn’t.

Repetition and continual touchpoints are critical for changing behavior over time, as consumer-facing industries know well. According to ‘Tangible Words’, The British Journal of General Practice, and the Robert Graham Center, it takes consumer marketers about 45 touchpoints to drive an action, and about 66 days of repetitive action to form a new behavior. On average, we see our doctor twice a year.

Given that frequent, persistent engagement is what influences new actions, people’s consistent attention is also key to changing their health behaviors. But is that feasible in today’s health system? Much as organizations like the American Heart Association urge health professionals to, say, discuss physical activity at every office visit, doctors can’t meet each patient every day of the week. The system simply isn’t set up for that level of contact. People need other opportunities to engage, and consumer marketing teaches us how to get it done.


An Engagement Partner

Several of our senior leaders at Well have been applying research in psychology and consumer behavior to other industries for decades. They understand how to gain and hold a consumer’s attention.

“The principles of behavioral economics and consumer science have been leveraged to great effect in nearly every other consumer-facing industry. I’ve seen the benefits firsthand while leading the marketing function at Caesars Entertainment. Healthcare would do well to adopt these tactics at scale, which means allowing meaningful health engagement to follow members out of the doctor’s office and into their day-to-day routines. ”

Ruben Sigala, Chief Marketing & Data Analytics Office


You might think changing health behavior is totally different than what works for a retailer or a gaming company, but the science shows that people behave in predictable patterns across contexts. A universal engagement principle is embedded with the old adage of “an apple a day keeps the doctor away. Indeed, our entire platform at Well is designed for frequent touchpoints and persistent interventions. We aim for members to be active on the platform for just a few minutes a day. That’s roughly 1,000 minutes a year. Not anywhere near your social media habit, but a heck of a lot more frequent than your doctor visits.

An apple a day. And it’s working. Our results show we can improve members’ health by 10% and save them $20 a month in direct medical costs. How do we do that?


Our Engagement Method

Our approach to health engagement at Well has two key components.


Applied consumer marketing tactics. Given that a typical shopper needs dozens of touchpoints before making a purchase, we ensure that on average we interact with each of our members over 35 times a month. This includes the use of SMS, email, push alerts, and chat outreach for an average of 25 proactive monthly contacts, in addition to the 10+ average interactions within the app itself. If a member hasn’t engaged with the app in a while, we reach out to remind them. If needed, we offer them a special reward to come back, much like an online store might offer you a discount or coupon code on a new sweater. Overall, 87% of our members say our level of communication is “just right.”The idea of “marketing” better health might nevertheless seem strange to you. Shouldn’t a desire for better health be motivating enough? Not quite. As with everything else in our busy lives and world, competing pressures and forces distract us from the actions we might intend to take. And after all, many health activities can be inherently uncomfortable or inconvenient, making engagement even harder. We accept that basic reality without judgment — and then apply to health behavior the engagement tactics that work reliably in other domains.

“Persistence, personalization and incentives support action in the consumer world, and inconvenience, delay and disappointment do the opposite. Unfortunately, health care is far more accurately characterized by the latter descriptors than the former.”

Gary Loveman, Co-Founder and CEO


High-quality touchpoints. We have seen that a few minutes of engagement is enough “apple” for each day. But the duration alone is not enough. It’s how the time is spent. A member can’t just think about anything related to general health for a few minutes. “Get your steps in” or “drink more water” means little in a vacuum. These simple entry points need to be coupled with actions that pack more of a punch. So, our program focuses on each individual’s specific health needs and context — your individual purpose — so that your engagement actually moves the needle for you.

To get results, the engagement must be well-rounded, so that it covers whole health topics and extends beyond traditional wellness categories. For example, instead of just focusing on how many steps were walked this week, a person’s program might include a notice about an overdue preventive cancer screening, a multi-day content stream on a balanced diet, a questionnaire about risk for depression, and a reminder to refill a prescription.          .

Being persistent and comprehensive goes a long way. But our team of clinicians and designers also constructs your content pathway to balance intrinsic and extrinsic encouragement, tailored to your own motivators, so that you achieve self-efficacy. Specifically, we layer in tangible rewards and celebrations, while mixing easy actions with more difficult ones you might be avoiding. 

For instance, Well hosts monthly challenges that offer incremental rewards for engaging in a certain way. One recent challenge encouraged a member to engage a Well Guide on the topic of fitness, which spurred a conversation on what kinds of fitness mattered to that member and then setting personalized, concrete health goals. This approach is more effective than asking someone to set fitness-related health goals at the outset, which can be a high-friction conversation. We smooth out that friction by guiding members to successes that are easier to achieve and, thereby, to greater self-efficacy. This challenge alone prompted one of every four members on our platform to engage in a Well Guide chat.

We never force a pathway, though, instead offering options and guidance and empowerment — not formulas or directives. Your “apple a day” is indeed your apple. We understand the science of what drives behavior, and we use it to help you chart your direction.

A couple of minutes a day can make a meaningful difference in your health, or in the health of someone you care about. “An apple a day” is not just an old adage — it’s a data-backed health solution that achieves tangible results.