MiLife: Health Coaching for All

MiLife: Health Coaching for All
Proven Behavioural Technology
©MiLife Coaching Limited
Today
• About MiLife
• Impact of lifestyle on healthy ageing
• Challenges of lifestyle and behaviour interventions
©MiLife Coaching Limited
©MiLife Coaching Limited
Lifestyle benefits to health
• Effects of lifestyle on health are well proven:
– Uni. Hong Kong / Dept. of Health, 2004: 20% of
deaths of people aged 35+ attributable to lack of
physical activity.
More than smoking!
– BMJ 2008 Sep – Study in US women over 24 Years:
55% of all-cause mortality attributable to having any
of four risk factors: being overweight, smoking
cigarettes, not engaging in physical activity, and
having a low healthy-diet score.
©MiLife Coaching Limited
But, when does Ageing start?
• Behaviours in earlier life have lifetime effects
– Inst. Of Community medicine, Ibaraki, Japan 1999
“… continuous exercise beginning in junior high
school, especially high-impact sports, may be
associated with greater current bone mass. It is
important to incorporate adequate exercise
beginning in the teenage years to lower one’s future
risk for osteoporosis.”
– Patel KV, et al Am. J Prev. Med 31(4), 2006
“… greater physical activity in your 30s, 40s and 50s
has beneficial effects well into the future by helping
us maintain our ability to walk and function at older
ages”
©MiLife Coaching Limited
©MiLife Coaching Limited
Is it too late?
• Changes in behaviour in later years can still be
beneficial
– Am. J. of Medicine 2007 Jul;120(7) - King et al
Turning back the clock: adopting a healthy lifestyle
in middle age. Adults 45-64yrs.
“People who newly adopt a healthy lifestyle in
middle-age experience a prompt benefit of lower
rates of cardiovascular disease and mortality.
Strategies to encourage adopting healthy lifestyles
should be implemented, especially among people
with hypertension, diabetes, or low socioeconomic
status”
©MiLife Coaching Limited
OECD: POLICIES FOR HEALTHY AGEING
OECD HEALTH WORKING PAPERS NO. 42 (2009)
• “Better lifestyles are likely to be key to further
improvements in the longer-term health of the
elderly. But because they require changes to
individual behaviour, improvements in this
policy dimension may be difficult to engineer.
While it is “never too early and never too late”
to change lifestyles, it is clear that, the earlier
risky behaviour changes, the higher the
chances of enjoying longer healthy lives”
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How can people be persuaded to
change behaviour…
?
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©MiLife Coaching Limited
MiLife
Behaviour Change For All
•
MiLife is an automated behavior change
system that is discrete to wear and
easy to use.
•
MiLife tracks everyday activity and
weight.
•
MiLife operates in 4 modes:
–
•
Get Active; Weight Loss; Weight
Maintenance; Healthy Lifestyle
MiLife is dedicated to being credible
and improving service through
research.
–
(3 published papers with peer review)
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“Prevention is better than cure…”
…and lifestyle change is better at prevention than drugs.
Cumulative Incidence of
Diabetes ( %)
40
Placebo
30
Metformin
Lifestyle
20
58% reduction
in risk of type 2
Diabetes
10
0
0
0.5 1.0 1.5 2.0 2.5 3.0 3.5 4.0
Year
Diabetes Prevention Program (Knowler et al., 2002)
150 minutes Moderate Physical Activity; lose 7% weight
©MiLife Coaching Limited
The Challenge: Providing Behaviour Change that is
convenient & affordable and still efficacious
Face to Face Coaching
Behaviour Change Theory
‘Remote’ Coaching
Behaviour Change Theory
Effective
Effective
Time intensive!
Convenient!
Expensive!
Affordable!
£
£
£
£
££
£
Personal Coaching on Mass Scale
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Evolution of Technology for
Scalable & Effective Behaviour Change
2000-05
2005-8
WEB

2009DEVICE
WEB

DEVICE
WEB
BEHAVIOUR
CHANGE
©MiLife Coaching Limited
Data/Knowledge alone is not enough!
• The key to the efficacy of MiLife is the feedback to the
user that is generated in response to the gathered data
• Sensors and devices are vital to an effective system,
but they are one part of the overall solution
• User feedback needs to be personal and not just a
mountain of data
• Data in and of itself is not sufficient to change
behaviour!
©MiLife Coaching Limited
Lifestyle
Lifestyle Devices
Devices
Physical Activity Monitor
(Tri-axial Accelerometer)
1 Week
Smart Scales
Thursday
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The
The Coaching
Coaching System
System
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Calorie recording
Automatic entry by SMS
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Structured and unstructured activity
Cutting the grass
60 mins moderate, 20 mins high, 2 mins very high activity
Strimming
158 mins moderate & 46 mins high activity
37 mins activity
Step Class
Walking with friends
Night out – Karaoke!
41 minutes of activity
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Human Trials History
Year
Target
Behaviour
Components
Outcomes
2004
Trial 1
Physical Activity
Web & Adaptive System
Engagement vs.
standard web sites
2005
Trial 2
Physical Activity
Activity Monitor, Web &
Adaptive System
Objective
Behaviour Change +138mins physical
activity
2007
Trial 3
Physical Activity; Smart Scales, Activity
Eating; Weight
Monitor, Web &
Adaptive System
Larger scale
engagement,
deployment & Weight
loss, sleep quality
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•Men were more likely
than women to select
“heart disease” and
“blood pressure” as
reasons for
participating
•Women were more
likely to select “look
better” and “slimmer”.
•Selection of the goal
“blood pressure” was
associated with
continued use of the
program following the
study period (p<0.012).
©MiLife Coaching Limited
Other Data
• 6mmHg reduction in Diastolic Blood Pressure
(p<0.001)
• increase in Sleep Quality - decreased Global
PSQI score (p=0.004), including
– Improved self-assessed overall sleep quality
(p=0.0002)
– Increased hours of actual sleep achieved (p=0.0095)
– Improved ease of both maintaining attention and/or
enthusiasm for everyday tasks (p=0.0057)
• 12 month follow up shows most users who lost
weight in initial 3 months are still below their
baseline weight.
©MiLife Coaching Limited
Collaborations
• Blood Pressure Association
• Diabetes UK
• Several Primary Care Trusts in UK
• Tesco Diets
• ? Others
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MiLife Case Study: Angela May
•
Lost 3 stone (19Kg) in 6 months with MiLife
•
Went from a size 14/16 to a size 10
•
Qualified nutritionist but still got overweight
•
Now works as a clinical researcher
“It’s changed my life and it
wasn’t all that hard; I didn’t
have to follow some stupid
milkshake or soup diet and
it didn’t stop me eating the
foods I wanted to eat!”
6 months later
©MiLife Coaching Limited
The major challenges
• Changes in lifestyle are impacted directly by
human behaviour which in turn has many
complex influences:
–
–
–
–
–
–
–
Social
Biological
Economic
Cultural
Educational
Environmental
Political
• These require cross disciplinary approaches!
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Can technology alone help to
motivate?
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Opportunities…
• How does Technology usability affect potential
for behaviour change?
• How does branding affect engagement of
users?
• Indirect lifestyle changes – importance of
social networks and community
• Developing and deploying objective
physiological, behavioural and social measures
of quality of life
©MiLife Coaching Limited
Behavioural opportunities
• How to best characterise and understand an individual
when working remotely in terms of:
– Their health awareness and goals
– The level of importance that health has in their life
and why – barriers or enablers…
– The link between these and current behaviour
– The link between current understanding, goals,
motivation and future behaviour
– Understanding of the biological and psychological
bases of food preferences, behavioural responses to
food, physical activity and healthy lifestyle
©MiLife Coaching Limited
Parting thoughts…
• “Every human being is the author of his own
health or disease”
– Gautama Siddharta, founder of Buddhism, 563-483
B.C.
• “The only way to keep your health is to eat
what you don’t want, drink what you don’t
like, and do what you’d rather not!”
– Mark Twain
©MiLife Coaching Limited
Thank You
©MiLife Coaching Limited