Click here for a print copy (5 pages, PDF).
Don't miss the next WellSpring. Subscribe to CAL's Active Living E-News to receive our monthly notice.
By Peter Rawlek, MD, Emergency Room Physician and Clinical Preceptor with the University of Alberta Hospital’s Red Deer site located at Red Deer Regional Hospital, as well as Founder and CEO of GoGet.Fit
The GoGet.Fit application is one tool that can be used by healthcare professionals to help support clients’ physical activity and progress in building an active lifestyle.
This WellSpring provides an overview of the GoGet.Fit app’s features, as well as some of its successes.
It was my last shift in the stretch of a 5-day tour at a regional emergency department (ED). I had to call an end to another resuscitation attempt, the third failed resuscitation in two shifts. All males in their late forties. All cardiac arrests. I was a bit shell-shocked with what had just happened. Collecting my thoughts, I prepared myself to make that walk to the family room. Behind that door, sat, in waiting, his wife, his two children, and his parents. This is the reality of some of my work as an emergency department physician and as a member of the medical community.
Upon reviewing the ED visits over two shifts in our department, we discovered that 78% of the people seen in the ED would likely not have been there had they been more active. Combined with climbing healthcare costs due to an increasing number of “sick” people flooding EDs across the province (40.6% of provincial program spending and climbing 0.2-0.3% annually),1 something needed to be done. I knew we had to start doing something differently.
Of the 80% of Canadians who do not meet the minimum physical activity guidelines (150 min/wk of moderate-to-vigourous activity to achieve health benefits), most will suffer from Lifestyle Modifiable Disease (LMD) burdens.2,3 Within this group, there are two sub-populations:
- those with previous exercise experience; and
- those with little or no previous exercise experience.
There are three differences between the exercise-experienced versus those who are not experienced, which can determine the probability of success in the pursuit to become physically active in later life.4,5
Figure 1. Three differences between individuals with exercise experience and with no exercise experience.
Development of the GoGet.Fit application
Five years ago, GoGet.Fit established a research and development team consisting of health and fitness professionals as well as researchers. At the foundation, guiding all design decisions, were over 200 key academic papers that were assembled. These also informed our in-house examination of 2,500 of the most popular fitness technologies on the market. Guiding our examination was the understanding that motivation does not beget transformation. As a result, the GoGet.Fit health engagement platform focused its design decisions on supporting the exercise-naive population.
Figure 2. The fitness technology industry versus GoGet.Fit.
Providing information with the goal to motivate someone to start only gets them out of the starting blocks. Continuation requires some transformation, where both commitment and support are key. The transformative process happens after the motivation to start. The transformation is a process in life where one can overcome challenges, with supports and solid behaviour techniques, before they become barriers that result in quitting.
Transformation in life happens with support. Like the athlete who is struggling or beginning to quit on themselves, the coach is there to support them. Overcoming challenges and experiencing success, builds and strengthens a client’s self-efficacy. Greater self-efficacy dramatically changes compliance to a physical activity plan; the basis upon which this app is built. It is designed to support both the client and the healthcare/fitness professional.
Charting a novel course: incorporating behavioural control techniques and avoiding short-falls
GoGet.Fit’s design decisions focused on scheduling (and logging) for all users. By having the exercise-initiate perform the actions of scheduling and logging, they are laying down key mental pathways that will result in long lasting exercise engagements.
GoGet.Fit is anchored by a trifecta of pillars: networking healthcare providers with community-based fitness partners, behavioural support or accountability for participants, and a continual stream of educational content.
1. GoGet.Fit networks the clinic/office-situated healthcare professionals with community-based fitness partners.
After the healthcare providers get clients started, they connect with community-based fitness partners who provide community-centered supports and guidance. This networking is a necessary bridge from intent to transformation, particularly when it is tied to accountability and support.
Key tools for professionals include:
- GoGet.Fit Pro Portal
The Pro Portal provides efficient tracking and monitoring of large numbers of related users. The Pro Portal weekly aggregates all one’s clients’ adherence outcomes. It analyzes each outcome with pre-set algorithms and places them in categories of adherence that, at a glance, the professional immediately knows how their clients are performing. In minutes, one can be finished with providing scaled supportive messaging, reflective of each cohort’s adherence outcomes.
- Scaled, personalized messaging
For each category, the professional can create or select a relevant generic message which the GoGet.Fit Pro Portal then personalizes to each intended recipient. With the investment of a few minutes, all users benefit from the professional’s support.
- Stored, pre-set exercise program templates
Exercise program templates are available to guide cohorts of users sharing similar active journeys. The templates guide clients through the smaller steps, moving them through the early phases of establishing physical activity habits. The templates are also time-savers (select and send) for those professionals invested in not only providing support, but also choosing to “manage” the journey of large user numbers efficiently.
Figure 3. Example of GoGet.Fit Pro Portal.
2. In the hands of the participants.
Participants are connected with an app designed to support habits that improve outcomes. The app consists of 24 behavioural change tools to build a strong foundation for success. Examples of tools include: intention formation, self-monitoring, goal-setting, action planning, barrier identification and problem solving, prompts to recommit to a missed target, rewards contingent upon effort and success, restriction of negative experiences, reflective exercises, cues and reminders, exercise contract agreements, and relapse prevention.
3. Weekly educational content
Expert educational content is curated on a weekly basis to inform and shift health perspectives gradually over time. Also, a variety of weekly support is provided from one’s professional team.
The combination of the three pillars creates a supportive structure for healthcare teams and professionals, as well as for their clients. The easy-to-use application uses a simple and time-efficient design for professionals and users alike, allowing for limited friction to adoption and continued use. More specifically, the remote tracking allows professionals to reach out to support and motivate their clients throughout their journey towards a more physically active lifestyle, independent of proximity.
Traction to date
According to the literature, the science and design underpinning the GoGet.Fit health engagement platform — exercise-initiates receiving support from personally valued professionals engaged in their journey, combined with a mobile device incorporating evidence-based support tools — should improve adherence outcomes by over 300%.6-12 Early indications from numerous pilots confirm these outcomes.
Examples of early successes and traction to date include:
- GoGet.Fit has remotely supported 43,872 workouts and 1,793,263 minutes.
- GoGet.Fit’s habit engagement platform actively supports seven exercise professionals and one frontline healthcare staff in eight Primary Care Networks (PCNs), teachers in two city high schools, two fitness facilities, and three healthcare practitioners.
- The Healthy Habits Start Here pilot, within Unit 22 of the Red Deer Regional Hospital, saw 44% of its patients become active at home after discharge through support from the GoGet.Fit habit engagement platform. There are plans to extend the pilot to other units within the hospital and externally to other hospitals in summer 2019.
- In one Edmonton Catholic high school, three teachers initiated a grade 10 pilot between Oct 8 to Nov 18, 2018. At the start, only 40,000 minutes of activity were logged among the 173 students. With support of the GoGet.Fit app, students logged 150,000 minutes of activity by the end.
GoGet.Fit is a team comprised of 12 staff: four computer engineers and eight success support staff in Australia and Canada. Our next steps are to educate frontline, healthcare associations and members (e.g., PCNs, physician clinics, nurses, and pharmacists) and community-based fitness partners (e.g., recreation facilities, private fitness contractors, and educational institutions), of the ease and simplicity in leveraging the GoGet.Fit platform to support patients and clients to be more active.
The GoGet.Fit Australia team is currently targeting fitness facilities and educational institutions in their go-to-market strategy. By May 2019, GoGet.Fit will be launching:
- Full clinical adoption and implementation pilot projects in clinics in Boston, USA and the Central and Edmonton Zones in Alberta; and
- A pilot reaching 20 recreation facilities within a major Alberta city.
To learn more and to get connected with the GoGet.Fit app, visit https://goget.fit.
About the Author
Peter Rawlek, MD, is the founder and CEO of GoGet.Fit. He is also an Emergency Room Physician and Clinical Preceptor with the University of Alberta Hospital’s Red Deer site located at Red Deer Regional Hospital.
In his 20’s, he was a member of the Canadian National Badminton team. Dr. Rawlek remains an avid adventurer, into everything from x-country skiing at home in Canmore to cold water surfing on the west coast.
- Fraser Institute. The Sustainability of Health Care Spending in Canada 2017. Published March 2017. Accessed February 17, 2019.
- Statistics Canada. Health Status of Canadians 2016: Report of the Chief Public Health Officer — What is influencing our health? — Physical activity. Published December 2016. Accessed December 20, 2018.
- Macridis S, Johnston N, Vallance J. 2017 Alberta Survey on Physical Activity. Published January 2017. Accessed December 20, 2018.
- Williams SL, French DP. What are the most effective intervention techniques for changing physical activity self-efficacy and physical activity behaviour--and are they the same? Health Educ Res. 2011;26(2):308-322. doi: 10.1093/her/cyr005.
- Bandura A. Self-efficacy: toward a unifying theory of behavioral change. Psychol Rev. 1977;84(2):191-215.
- Kerse N, Elley CR, Robinson E, Arroll B. Is physical activity counseling effective for older people? A cluster randomized, controlled trial in primary care. J Am Geriatr Soc. 2005;53(11):1951-1956. doi: 10.1111/j.1532-5415.2005.00466.x.
- Noordman J, Verhaak P, van Dulmen S. Discussing patient’s lifestyle choices in the consulting room: analysis of GP-patient consultations between 1975 and 2008. BMC Fam Pract. 2010;11:87. doi: 10.1186/1471-2296-11-87.
- Hinrichs T, Brach M. The general practitioner’s role in promoting physical activity to older adults: a review based on program theory. Curr Aging Sci. 2012;5(1):41-50.
- Armit CM, Brown WJ, Marshall AL, et al. Randomized trial of three strategies to promote physical activity in general practice. Preventive Medicine. 2009;48(2):156-163. doi: 10.1016/j.ypmed.2008.11.009.
- Campbell AJ, Robertson MC, Gardner MM, Norton RN, Tilyard MW, Buchner DM. Randomised controlled trial of a general practice programme of home based exercise to prevent falls in elderly women. BMJ. 1997;315(7115):1065-1069.
- Finkelstein EA, Brown DS, Brown DR, Buchner DM. A randomized study of financial incentives to increase physical activity among sedentary older adults. Preventive Medicine. 2008;47(2):182-187. doi: 10.1016/j.ypmed.2008.05.002.
- Lear SA, Singer J, Banner-Lukaris D, et al. Randomized trial of a virtual cardiac rehabilitation program delivered at a distance via the Internet. Circ Cardiovasc Qual Outcomes. 2014;7(6):952-959. doi: 10.1161/CIRCOUTCOMES.114.001230.
March 2019, Volume 30, No. 03
Click here for a print copy (5 pages, PDF).
|Don't miss the next WellSpring. Subscribe to CAL's Active Living E-News to receive our monthly notice.|