Behavior change continues to be a formidable challenge. Employers and health systems struggle to create meaningful and sustained change in an era when the field is at times divided on all too many issues--Single vs. multiple behavior interventions? Online vs. in-person programs? Culture vs. individual level interventions? Outcomes or participation-based incentives? In her nearly 20 years in the health promotion field, Dr. Sara Johnson, Senior Vice President of Research and Product Development at Pro-Change Behavior Systems, Inc., has been relentlessly pursuing innovations in health promotion and opportunities to integrate.
The mission of Pro-Change, a certified Women’s Business Enterprise and small business located in Rhode Island, is to develop and disseminate evidence-based behavior change solutions based on leading theories of health behavior change. The energy Sara brings to her work there is in part a reflection of the total commitment she has to what she is doing—striving every day to improve the health and well-being of individuals and populations. Jim Prochaska, founder of Pro-Change had this to say: “Sara knows that breakthroughs are driven by ideas, data and technology. As a young scientist, she has demonstrated the ability to integrate theoretical concepts with empirical data and technological advances to produce breakthroughs, particularly with important problems and populations.”
Sara Johnson, Ph.D.
Sara entered health promotion with a Ph.D. in Clinical Psychology because she is passionate about health. Throughout her career, she has received several academic honors, including a graduate fellowship, an Outstanding Clinical Scholarship Award from VACT Medical Center, and recognition for excellence in reviewing from Journal of Nutrition, Education, and Behavior. She has been awarded over $4.7 million in NIH grants. At the organization level, Pro-Change’s online health behavior change programs, many of which she spearheaded, received the Gold Award for Best Practices in Health Management from URAC, are featured on AHRQ’s Innovation Exchange, and are under review for NCQA certification.
Among her contributions, the most significant was leading the development of 6 of the 9 programs in Pro-Change’s LifeStyle Management Suite (Weight Management, Smoking Cessation, Exercise, Healthy Eating, Managing Blood Pressure, Managing Cholesterol). These mobile optimized programs, which provide tailored behavior change guidance, are now being successfully disseminated to over a million end users through Pro-Change’s partners. Sara also led the team that developed the Coaching Programs for each LifeStyle Program, enabling health coaches to deliver evidence-based feedback with perfect treatment fidelity. She also conceptualized the Clinical Dashboard and participated in its integration into the LifeStyle Suite. The Dashboard displays for health care providers an overview of patients’ behavior change profile, along with brief behavior change messages matched to patients’ readiness to change each behavior. The Dashboard will soon be available to clinicians in as many as 300 onsite clinics through a partnership with HealthStat.
The Weight Management Program is among the most successful interventions. The online, mobile-optimized intervention provides individually tailored feedback for up to three behaviors: exercise, healthy eating, and emotional eating. In a randomized trial including 1265 overweight/obese employees, there were significant effects on behavior change at the 24-month extended follow-up (i.e., 47.5% treatment versus 34.3% comparison adopted healthy eating, 44.9% versus 38.1% adopted exercise, and 49.7% versus 30.3% stopped emotional eating) as well as weight loss (30% of treatment group participants lost 5% or more of weight). There was also significant coaction (individuals progressing to Action/Maintenance for a single behavior were 2.5-5 times more likely to make progress on another behavior). The findings, published in a special issue of Preventive Medicine, advanced the science of multiple behavior change interventions. The paper was the 7th most frequently downloaded in the journal’s history within two years.
The Welcoa benchmarks guide the development and dissemination, and evaluation of Sara’s interventions.
In a recent column in Health Promotion Practitioner, Paul Terry described Sara as “a leader with little trouble directing others…She is one for the experts stuck on fragmented thinking to follow.”
Sara has led numerous innovative initiatives to promote health and well-being including developing multiple behavior change interventions for weight and medication adherence. She strives to lead the field in leveraging an integrative approach to maximize impact (e.g., integrating evidence-based behavior change programs with evidence-based incentive platforms). She has nearly 40 publications including refereed publications, chapters, and published reports. Sara acts as a role model for others by religiously exercising and eating healthy. Sara credits SBIR funding and the autonomy Pro-Change has afforded her to pursue her visions for facilitating her ability to lead. She’d advise future leaders to be willing to take risks, collaborate, and listen to others—especially end users. The best leaders are good listeners.
Sara has repeatedly advanced population health management. Specifically, she:
The biggest opportunities for the health promotion industry are integration, promoting our value by linking health outcomes to well-being and performance, and leveraging technology to advance our mission.
In the next five years, I plan to pursue multiple initiatives to advance the industry, including: