Clinical trial NCT04289623: Assessing the Impact of myHealth Rewards Program-related Communications on Enrollment: Replication
Official title: Assessing the Impact of myHealth Rewards Program-related Communications on Enrollment: Replication
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Health Promotion
Wellness Program
Keywords: Prospect theory
Social norms
Social proof
Authority
Lead sponsor: Geisinger Clinic
Sponsor class: OTHER
First posted: 2020-02-28
Enrollment: 13546
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Observational model: CASE_CONTROL
Time perspective: PROSPECTIVE
Sampling method: PROBABILITY_SAMPLE
Study population: The population consists of Geisinger Health System employees who are also Geisinger Health Plan members and are not currently enrolled in myHealth Rewards.

Brief summary: The purpose of the study is to evaluate, prospectively, the potential impact on myHealth Rewards wellness program enrollment (prior to the 2020 deadline) of sending different messages via email to Geisinger Health Plan (GHP) members who have not yet enrolled. In particular, this study aims to replicate and extend (with greater sample size and statistical power) the findings from a previous study in which email communication using loss framing language achieved significantly higher click-through rates than a more standard communication, whereas actual enrollment rates were not significantly higher.

Detailed description: 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), about 23% of eligible existing GHP members did not enroll during the primary 2019 enrollment period, even after receiving promotional email communications and reminders.

Previous work examining myHealth Rewards found that email communication using loss framing language achieved significantly higher click-through rates than a more standard communication, whereas actual enrollment rates were not statistically significantly higher.

The current study aims to analyze de-identified Geisinger Health Plan (GHP) member data, comparing enrollment status (and secondarily, click-through rates) within the 2020 enrollment period across email conditions to which GHP members will be randomly assigned. The main part of this study will compare the effects of a standard, generic communication vs. communication with loss framing, using a larger sample size for adequate statistical power to detect the original difference in enrollment rates as significant, should that difference be real and reliable. Additional conditions are added after this main comparison in order to compare more precisely other pairs of communications conceived in the original study.

The generic email condition will consist of a standard email of the kind that would typically be sent by GHP to encourage enrollment, which includes the average amount saved, the ease of registration, and a reward incentive. The loss framing condition will highlight that respondents are forfeiting savings unless they take action and register. The two testimonial conditions will have a testimonial from a doctor (medical expert condition) or a customer care specialist (rank-and-file condition) about how the program helped them. The two social norms conditions will show the percentage (percentage condition) or number (number condition) of fellow Geisinger members who already signed up. Emails will go out in three waves. For each wave, Geisinger employees who have not already registered at that time will be randomized into one of two groups:

Wave 1: generic email vs. loss framing email

Wave 2: testimonial (expert) vs. testimonial (rank-and-file)

Wave 3: social norms (percentage) vs. social norms (number)

It is hypothesized that, on average, the loss frame email will increase enrollment compared with the standard email. The other comparisons are exploratory and do not have a priori hypotheses. Findings will help inform how best to increase enrollment in a wellness program through email communication.

Eligibility criteria: Inclusion Criteria:

* Geisinger Health Plan members
* Geisinger Health System employees who have not yet enrolled in myHealth Rewards

Exclusion Criteria:

* Enrollment in myHealth Rewards before the email launch date for each wave
* Do not have an email address on file

Primary outcomes:
measure: Rate of Enrollment (14 Days)
timeFrame: 14 days
measure: Rate of Logging in (14 Days)
timeFrame: 14 days
Secondary outcomes:
Other outcomes:
Locations:
city: Danville
country: United States
facility: Geisinger
state: Pennsylvania
Study officials:
affiliation: Geisinger Clinic
name: Amir Goren, PhD
role: PRINCIPAL_INVESTIGATOR
References: