Assessing the Impact of myHealth Rewards Enrollment Emails

Study Overview
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Brief Summary
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The purpose of the study is to evaluate, prospectively, the potential impact of different email message conditions (no email, standard promotional email, social norms, and loss framing) on enrollment in a wellness program (myHealth Rewards) by Geisinger Health Plan (GHP) members.

Detailed Description
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The myHealth Rewards wellness program managed by GHP rewards those GHP members who carry their insurance through employment at Geisinger with reduced health insurance premiums over the course of the following year, if members register for the program and have their health measures on file by the enrollment deadline and are then able to meet their health goals by the respective due date. In spite of the potential savings to health plan members and the wellness program's potential to motivate engagement in healthy activities (with consequent improvement in health outcomes), over 20% of eligible GHP members have not yet enrolled in 2019, even after receiving promotional email communications and reminders. Therefore, the current study was developed to test whether different versions of emails are more effective than a standard reminder email or no-email condition in increasing myHealth Rewards login and enrollment rates. The standard email reminder mentions the average premium savings, the ease of the registration process, and the deadline for registering and having health measures on file, plus it provides links for registering and finding free health screenings where health measures can be collected and registered at one convenient time and location. The social norms email notes that a majority (78%) of GHP members' colleagues had enrolled in 2018, it provides a testimonial from a medical director at Geisinger's Commonwealth School of Medicine, stating the ways in which myHealth Rewards helped that doctor personally, and it emphasizes the simplicity and ease of taking the first step toward enrollment. The loss framing email suggests that GHP members are currently throwing away a precise monetary amount in savings by not participating and that they can therefore avoid missing out on substantial gains (i.e., savings) by taking action. It is hypothesized that, on average, each of the emails will increase enrollment compared with no email. Among GHP members who never enrolled in the past, it is hypothesized that the standard email reminder will not be as effective as the social norms and loss framing emails. Therefore, email conditions will be compared separately among those who did and did not register in 2018. Findings will help inform how best to increase enrollment in a wellness program among health plan members who have already received past promotional communications and who may or may not have participated in the past.

Official Title
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Assessing the Impact of myHealth Rewards Program-related Email Communications on Enrollment

Conditions
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Health Promotion, Wellness Programs

Intervention / Treatment
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* Behavioral: Social norms
* Behavioral: Loss framing
* Behavioral: Email reminder


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Geisinger employees who are benefits subscribers Exclusion Criteria: Those who had already registered for myHealth Rewards in 2019, up through May 6, 2019 New Geisinger employees hired between December 1, 2018 and May 6, 2019 Existing Geisinger employees who transitioned from non-subscribers in 2018 to subscribers in 2019

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| No email<br>No email will be sent out to this subset of GHP members during the week that the other emails are sent. | |
| Standard email reminder<br>The standard email reminder mentions the average premium savings, the speed and ease of starting the process, and the deadline for registering and having health measures on file, plus it provides two button links for registering and finding free health screenings where health measures can be collected and registered at one convenient time and location. | Behavioral: Email reminder<br>* This intervention is a standard email reminder that mentions the average premium savings, the speed and ease of starting the process, and the deadline for registering and having health measures on file, plus it provides two button links for registering and finding screenings.<br>|
| Social norms email<br>The social norms email notes that a majority (78%) of GHP members' colleagues had enrolled in 2018, it provides a testimonial from a medical director at Geisinger's Commonwealth School of Medicine, stating the ways in which myHealth Rewards helped that doctor personally, and it emphasizes the simplicity and ease of taking the first step toward enrollment. | Behavioral: Social norms<br>* This intervention introduces recipients to descriptive social norms specifying that a majority of their colleagues have signed up for the program, which sets a normative standard against which recipients are expected to compare themselves and to change their behavior accordingly (i.e., when they realize that their behavior is discrepant from that of relevant others). The personal testimonial from a Geisinger medical director serves as a personal exemplar intended to further enhance the effect of the social norms with an implicit indication that the intended behavior is desirable and feasible.<br>* Other names: Social proof;Behavioral: Email reminder<br>* This intervention is a standard email reminder that mentions the average premium savings, the speed and ease of starting the process, and the deadline for registering and having health measures on file, plus it provides two button links for registering and finding screenings.<br>|
| Loss framing<br>The loss framing email suggests that GHP members are currently throwing away a precise dollar amount (over $2,000) by not participating and that they can therefore avoid missing out on substantial gains (i.e., savings) by taking action. | Behavioral: Loss framing<br>* This intervention frames the status quo as a state from which recipients, via inaction, are slated to forfeit a sizable and precise monetary amount to which they should otherwise feel entitled (via loss aversion and the endowment effect). People tend to be risk-seeking in the domain of losses; therefore, this intervention is hypothesized to increase enrollment in the hope of achieving zero loss by meeting program goals, as opposed to a sure loss via inaction.<br>* Other names: Endowment effect;Behavioral: Email reminder<br>* This intervention is a standard email reminder that mentions the average premium savings, the speed and ease of starting the process, and the deadline for registering and having health measures on file, plus it provides two button links for registering and finding screenings.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Enrollment (7 Days) | Enrollment in the myHealth Rewards program (yes/no) within 7 full days of the beginning of the intervention (i.e., when the emails are first sent). | 7 days, from May 7 through 13, 2019 | 
| Logging in (7 Days) | Logging into the myHealth Rewards program (yes/no) within 7 full days of the beginning of the intervention. | 7 days, from May 7 through 13, 2019 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Prospect theory