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Assessing the Impact of myHealth Rewards Enrollment Emails

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ClinicalTrials.gov Identifier: NCT03965754
Recruitment Status : Completed
First Posted : May 29, 2019
Results First Posted : October 5, 2020
Last Update Posted : December 7, 2020
Sponsor:
Information provided by (Responsible Party):
Amir Goren, Geisinger Clinic

Study Type Observational
Study Design Observational Model: Case-Control;   Time Perspective: Prospective
Conditions Health Promotion
Wellness Programs
Interventions Behavioral: Social norms
Behavioral: Loss framing
Behavioral: Email reminder
Enrollment 5697
Recruitment Details  
Pre-assignment Details  
Arm/Group Title No Email Standard Email Reminder Social Norms Email Loss Framing
Hide Arm/Group Description No email will be sent out to this subset of GHP members during the week that the other emails are sent. 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. 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 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.
Period Title: Overall Study
Started [1] 1422 1425 1425 1425
Completed [2] 1422 1425 1425 1425
Not Completed 0 0 0 0
[1]
No email bounce information was available, so this number includes all people emailed.
[2]
Given no bounce information, all emails were considered received, which we counted as completion.
Arm/Group Title No Email Standard Email Reminder Social Norms Email Loss Framing Total
Hide Arm/Group Description No email will be sent out to this subset of GHP members during the week that the other emails are sent. 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. 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 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. Total of all reporting groups
Overall Number of Baseline Participants 1422 1425 1425 1425 5697
Hide Baseline Analysis Population Description
The baseline outcome measure was not applicable, since enrollment and login in response to the email was the outcome. There was no previous email, and participants were selected for not having enrolled in the year of the study period.
Age, Categorical   [1] 
Measure Type: Count of Participants
Unit of measure:  Participants
Number Analyzed 1422 participants 1425 participants 1425 participants 1425 participants 5697 participants
<=18 years NA [2]  NA [2]  NA [2]  NA [2]  NA [3] 
Between 18 and 65 years NA [2]  NA [2]  NA [2]  NA [2]  NA [3] 
>=65 years NA [2]  NA [2]  NA [2]  NA [2]  NA [3] 
[1]
Measure Description: Only de-identified data on email engagement was collected; no age data was collected.
[2]
Data not collected
[3]
Total not calculated because data are not available (NA) in one or more arms.
Sex: Female, Male   [1] 
Measure Type: Count of Participants
Unit of measure:  Participants
Number Analyzed 1422 participants 1425 participants 1425 participants 1425 participants 5697 participants
Female NA [2]  NA [2]  NA [2]  NA [2]  NA [3] 
Male NA [2]  NA [2]  NA [2]  NA [2]  NA [3] 
[1]
Measure Description: Only de-identified data on email engagement was collected; no sex or gender data was collected.
[2]
Data not collected
[3]
Total not calculated because data are not available (NA) in one or more arms.
Race and Ethnicity Not Collected   [1] 
Measure Type: Count of Participants
Unit of measure:  Participants
Number Analyzed 0 participants 0 participants 0 participants 0 participants 0 participants
0
[1]
Measure Analysis Population Description: Race and Ethnicity were not collected from any participant.
Region of Enrollment  
Measure Type: Number
Unit of measure:  Participants
United States Number Analyzed 1422 participants 1425 participants 1425 participants 1425 participants 5697 participants
1422 1425 1425 1425 5697
1.Primary Outcome
Title Enrollment (7 Days)
Hide Description 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).
Time Frame 7 days, from May 7 through 13, 2019
Hide Outcome Measure Data
Hide Analysis Population Description
We planned a priori to specifically compare the conditions within two groups: employees who previously enrolled and employees who never enrolled.
Arm/Group Title No Email Standard Email Reminder Social Norms Email Loss Framing
Hide Arm/Group Description:
No email will be sent out to this subset of GHP members during the week that the other emails are sent.
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.
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 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.
Overall Number of Participants Analyzed 1422 1425 1425 1425
Measure Type: Count of Participants
Unit of Measure: Participants
Previously Enrolled Number Analyzed 741 participants 742 participants 742 participants 742 participants
29
   3.9%
126
  17.0%
88
  11.9%
145
  19.5%
Never Enrolled Number Analyzed 681 participants 683 participants 683 participants 683 participants
4
   0.6%
8
   1.2%
6
   0.9%
13
   1.9%
Hide Statistical Analysis 1
Statistical Analysis Overview Comparison Group Selection No Email, Loss Framing
Comments We conducted a logistic regression with the three email conditions as dummy variables with no email as the reference group (among employees who previously enrolled in the program).
Type of Statistical Test Superiority
Comments [Not Specified]
Statistical Test of Hypothesis P-Value <.001
Comments We used an a priori threshold of p < .05.
Method Regression, Logistic
Comments [Not Specified]
Method of Estimation Estimation Parameter Odds Ratio (OR)
Estimated Value 5.96
Confidence Interval (2-Sided) 95%
4.00 to 9.18
Estimation Comments [Not Specified]
Hide Statistical Analysis 2
Statistical Analysis Overview Comparison Group Selection No Email, Standard Email Reminder
Comments We conducted a logistic regression with the three email conditions as dummy variables with no email as the reference group (among employees who previously enrolled in the program).
Type of Statistical Test Superiority
Comments [Not Specified]
Statistical Test of Hypothesis P-Value <.001
Comments We used an a priori threshold of p < .05.
Method Regression, Logistic
Comments [Not Specified]
Method of Estimation Estimation Parameter Odds Ratio (OR)
Estimated Value 5.02
Confidence Interval (2-Sided) 95%
3.36 to 7.76
Estimation Comments [Not Specified]
Hide Statistical Analysis 3
Statistical Analysis Overview Comparison Group Selection No Email, Social Norms Email
Comments We conducted a logistic regression with the three email conditions as dummy variables with no email as the reference group (among employees who previously enrolled in the program).
Type of Statistical Test Superiority
Comments [Not Specified]
Statistical Test of Hypothesis P-Value <.001
Comments We used an a priori threshold of p < .05.
Method Regression, Logistic
Comments [Not Specified]
Method of Estimation Estimation Parameter Odds Ratio (OR)
Estimated Value 3.30
Confidence Interval (2-Sided) 95%
2.17 to 5.17
Estimation Comments [Not Specified]
Hide Statistical Analysis 4
Statistical Analysis Overview Comparison Group Selection No Email, Loss Framing
Comments We conducted a logistic regression with the three email conditions as dummy variables with no email as the reference group (among employees who never enrolled in the program).
Type of Statistical Test Superiority
Comments [Not Specified]
Statistical Test of Hypothesis P-Value .038
Comments We used an a priori threshold of p < .05.
Method Regression, Logistic
Comments [Not Specified]
Method of Estimation Estimation Parameter Odds Ratio (OR)
Estimated Value 3.28
Confidence Interval (2-Sided) 95%
1.16 to 11.71
Estimation Comments [Not Specified]
Hide Statistical Analysis 5
Statistical Analysis Overview Comparison Group Selection No Email, Standard Email Reminder
Comments We conducted a logistic regression with the three email conditions as dummy variables with no email as the reference group (among employees who never enrolled in the program).
Type of Statistical Test Superiority
Comments [Not Specified]
Statistical Test of Hypothesis P-Value .256
Comments We used an a priori threshold of p < .05.
Method Regression, Logistic
Comments [Not Specified]
Method of Estimation Estimation Parameter Odds Ratio (OR)
Estimated Value 2.01
Confidence Interval (2-Sided) 95%
0.63 to 7.54
Estimation Comments [Not Specified]
Hide Statistical Analysis 6
Statistical Analysis Overview Comparison Group Selection No Email, Social Norms Email
Comments We conducted a logistic regression with the three email conditions as dummy variables with no email as the reference group (among employees who never enrolled in the program).
Type of Statistical Test Superiority
Comments [Not Specified]
Statistical Test of Hypothesis P-Value .531
Comments We used an a priori threshold of p < .05.
Method Regression, Logistic
Comments [Not Specified]
Method of Estimation Estimation Parameter Odds Ratio (OR)
Estimated Value 1.50
Confidence Interval (2-Sided) 95%
0.43 to 5.89
Estimation Comments [Not Specified]
Hide Statistical Analysis 7
Statistical Analysis Overview Comparison Group Selection Standard Email Reminder, Loss Framing
Comments We conducted a logistic regression with the two experimental conditions as dummy variables with the standard email as the reference group (among employees who previously enrolled in the program).
Type of Statistical Test Superiority
Comments [Not Specified]
Statistical Test of Hypothesis P-Value .202
Comments We used an a priori threshold of p < .05.
Method Regression, Logistic
Comments [Not Specified]
Method of Estimation Estimation Parameter Odds Ratio (OR)
Estimated Value 1.19
Confidence Interval (2-Sided) 95%
0.91 to 1.54
Estimation Comments [Not Specified]
Hide Statistical Analysis 8
Statistical Analysis Overview Comparison Group Selection Standard Email Reminder, Social Norms Email
Comments We conducted a logistic regression with the two experimental conditions as dummy variables with the standard email as the reference group (among employees who previously enrolled in the program).
Type of Statistical Test Superiority
Comments [Not Specified]
Statistical Test of Hypothesis P-Value .005
Comments We used an a priori threshold of p < .05.
Method Regression, Logistic
Comments [Not Specified]
Method of Estimation Estimation Parameter Odds Ratio (OR)
Estimated Value 0.66
Confidence Interval (2-Sided) 95%
0.49 to 0.88
Estimation Comments [Not Specified]
Hide Statistical Analysis 9
Statistical Analysis Overview Comparison Group Selection Standard Email Reminder, Loss Framing
Comments We conducted a logistic regression with the two experimental conditions as dummy variables with the standard email as the reference group (among employees who never enrolled in the program).
Type of Statistical Test Superiority
Comments [Not Specified]
Statistical Test of Hypothesis P-Value .276
Comments We used an a priori threshold of p < .05.
Method Regression, Logistic
Comments [Not Specified]
Method of Estimation Estimation Parameter Odds Ratio (OR)
Estimated Value 0.75
Confidence Interval (2-Sided) 95%
0.69 to 4.16
Estimation Comments [Not Specified]
Hide Statistical Analysis 10
Statistical Analysis Overview Comparison Group Selection Standard Email Reminder, Social Norms Email
Comments We conducted a logistic regression with the two experimental conditions as dummy variables with the standard email as the reference group (among employees who never enrolled in the program).
Type of Statistical Test Superiority
Comments [Not Specified]
Statistical Test of Hypothesis P-Value .592
Comments We used an a priori threshold of p < .05.
Method Regression, Logistic
Comments [Not Specified]
Method of Estimation Estimation Parameter Odds Ratio (OR)
Estimated Value 0.75
Confidence Interval (2-Sided) 95%
0.25 to 2.16
Estimation Comments [Not Specified]
2.Primary Outcome
Title Logging in (7 Days)
Hide Description Logging into the myHealth Rewards program (yes/no) within 7 full days of the beginning of the intervention.
Time Frame 7 days, from May 7 through 13, 2019
Hide Outcome Measure Data
Hide Analysis Population Description
There was no login data for participants in the "No email" group, as the website link was provided by the email. In addition, we planned a priori to specifically compare the conditions within two groups: employees who previously enrolled and employees who never enrolled.
Arm/Group Title No Email Standard Email Reminder Social Norms Email Loss Framing
Hide Arm/Group Description:
No email will be sent out to this subset of GHP members during the week that the other emails are sent.
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.
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 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.
Overall Number of Participants Analyzed 0 1425 1425 1425
Measure Type: Count of Participants
Unit of Measure: Participants
Previously Enrolled Number Analyzed 0 participants 742 participants 742 participants 742 participants
0
182
  24.5%
117
  15.8%
222
  29.9%
Never Enrolled Number Analyzed 0 participants 683 participants 683 participants 683 participants
0
25
   3.7%
19
   2.8%
42
   6.1%
Hide Statistical Analysis 1
Statistical Analysis Overview Comparison Group Selection Standard Email Reminder, Loss Framing
Comments [Not Specified]
Type of Statistical Test Superiority
Comments We conducted a logistic regression with the two experimental conditions as dummy variables with the standard email as the reference group (among employees who previously enrolled).
Statistical Test of Hypothesis P-Value .020
Comments We used an a priori threshold of p < .05.
Method Regression, Logistic
Comments [Not Specified]
Method of Estimation Estimation Parameter Odds Ratio (OR)
Estimated Value 1.31
Confidence Interval (2-Sided) 95%
1.04 to 1.65
Estimation Comments [Not Specified]
Hide Statistical Analysis 2
Statistical Analysis Overview Comparison Group Selection Standard Email Reminder, Social Norms Email
Comments We conducted a logistic regression with the two experimental conditions as dummy variables with the standard email as the reference group (among employees who previously enrolled).
Type of Statistical Test Superiority
Comments [Not Specified]
Statistical Test of Hypothesis P-Value <.001
Comments We used an a priori threshold of p < .05.
Method Regression, Logistic
Comments [Not Specified]
Method of Estimation Estimation Parameter Odds Ratio (OR)
Estimated Value 0.58
Confidence Interval (2-Sided) 95%
0.44 to 0.75
Estimation Comments [Not Specified]
Hide Statistical Analysis 3
Statistical Analysis Overview Comparison Group Selection Standard Email Reminder, Loss Framing
Comments We conducted a logistic regression with the two experimental conditions as dummy variables with the standard email as the reference group (among employees who never enrolled).
Type of Statistical Test Superiority
Comments [Not Specified]
Statistical Test of Hypothesis P-Value .359
Comments We used an a priori threshold of p < .05.
Method Regression, Logistic
Comments [Not Specified]
Method of Estimation Estimation Parameter Odds Ratio (OR)
Estimated Value 0.75
Confidence Interval (2-Sided) 95%
0.41 to 1.38
Estimation Comments [Not Specified]
Hide Statistical Analysis 4
Statistical Analysis Overview Comparison Group Selection Standard Email Reminder, Social Norms Email
Comments [Not Specified]
Type of Statistical Test Superiority
Comments We conducted a logistic regression with the two experimental conditions as dummy variables with the standard email as the reference group (among employees who never enrolled).
Statistical Test of Hypothesis P-Value .035
Comments [Not Specified]
Method Regression, Logistic
Comments We used an a priori threshold of p < .05.
Method of Estimation Estimation Parameter Odds Ratio (OR)
Estimated Value 1.72
Confidence Interval (2-Sided) 95%
1.05 to 2.90
Estimation Comments [Not Specified]
Time Frame No adverse events were evaluated.
Adverse Event Reporting Description We only received aggregate information about email engagement with no individual-level information collected (including those for adverse events).
 
Arm/Group Title No Email Standard Email Reminder Social Norms Email Loss Framing
Hide Arm/Group Description No email will be sent out to this subset of GHP members during the week that the other emails are sent. 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. 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 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.
All-Cause Mortality
No Email Standard Email Reminder Social Norms Email Loss Framing
Affected / at Risk (%) Affected / at Risk (%) Affected / at Risk (%) Affected / at Risk (%)
Total   0/0   0/0   0/0   0/0 
Hide Serious Adverse Events
No Email Standard Email Reminder Social Norms Email Loss Framing
Affected / at Risk (%) Affected / at Risk (%) Affected / at Risk (%) Affected / at Risk (%)
Total   0/0   0/0   0/0   0/0 
Hide Other (Not Including Serious) Adverse Events
Frequency Threshold for Reporting Other Adverse Events 0%
No Email Standard Email Reminder Social Norms Email Loss Framing
Affected / at Risk (%) Affected / at Risk (%) Affected / at Risk (%) Affected / at Risk (%)
Total   0/0   0/0   0/0   0/0 
For this study, we only received data about engagement with the email. Individual patients were not identified and demographic information such as age, sex, or gender were not collected.
Certain Agreements
All Principal Investigators ARE employed by the organization sponsoring the study.
Results Point of Contact
Layout table for Results Point of Contact information
Name/Title: Amir Goren, PhD
Organization: Geisinger Clinic
Phone: 5702144395
EMail: agoren@geisinger.edu
Layout table for additonal information
Responsible Party: Amir Goren, Geisinger Clinic
ClinicalTrials.gov Identifier: NCT03965754    
Other Study ID Numbers: 2019-0404
First Submitted: May 24, 2019
First Posted: May 29, 2019
Results First Submitted: September 11, 2020
Results First Posted: October 5, 2020
Last Update Posted: December 7, 2020