ENTRY FROM: The Top 100 Health Promotion Professionals

Nominee: Sara Johnson, Ph.D.

Changing Population Health One Stage at a Time

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.

Professional Development

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.

Demonstrated Success

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.

  • Capturing CEO Support—Building the rigorous evidence base to promote the value on investment of health and well-being promotion (all programs now include Well-Being assessment)
  • Creating Cohesive Wellness Teams—Ensuring participants, health coaches, and health care providers can all leverage the tools via an integrated database
  • Carefully Crafting an Operating Plan-Collaborating closely with partners to determine how to optimize participation, engagement, and outcomes (e.g., integrating the Clinical Dashboard into the electronic health record at onsite clinics)
  • Choosing Appropriate Interventions—Providing intervention delivery options (print, online, coaching) to enable partners to choose the most appropriate options and ensuring all participants receive tailored messaging (e.g., LifeStyle Suite)
  • Creating a Supportive Environment—Teaching partners about readiness to change helps them overcome the “action paradigm” and transform programs to be inclusive of people in all stages (e.g., implementing stage-matched recruitment messages in a large hospital system to increase engagement)
  • Collecting Data & Carefully Evaluating Outcomes- Capturing data automatically; Conducting multivariate statistical analyses to determine the decision rules that produce the feedback and ongoing evaluation of the programs in different employee populations and delivery channels (e.g., grant submitted to explore effectiveness of Smoking Program + texts+ incentives+ varenicline in underserved patients)

Leadership Success

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:

  • Developed the first population-based multiple behavior intervention for adherence (14.8% vs. 44.4% discontinuation; 55.6% adherence rate among previously non-adherent patients; and significant increases in exercise and healthy eating)
  • Developed a multiple behavior individualized interventions for weight that produced behavior change, weight loss, and coaction
  • Implemented “optimal tailoring” within a multiple behavior change program for college students that resulted in significant behavior change for exercise, fruit and vegetable intake as stress and increases in well-being
  • Integrated Pro-Change’s Smoking Cessation Program (plus texts) with a behavioral economics-based incentive platform to achieve 2X the rate of target participation, 3X the rate of program completion, and 2X the quit rates at 6 months
  • Relentlessly pursues applications of behavior change theory to new areas (e.g., a Clinical Dashboard to enable clinicians to provide behavior change guidance to patients, gaming for health; and pain self-management for Veterans)

Compelling Vision

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:

  • Expanding my work in the application of leading theories of and best practices in health behavior change to population-based financial well-being programs to promote overall well-being
  • Developing evidence-based programs for sleep to improve health, well-being, and productivity
  • Developing apps that leverage wearable sensor data to drive not just information display but individually tailored behavior change guidance for multiple behaviors  
  • Creating assessments of culture of health that more comprehensively address well-being rather than wellness
  • Promoting co-action through simultaneous policy/organizational/cultural and individual-level interventions
  • Continuing to integrate evidence-based behavior change solutions 1) with innovative solutions of partners and 2) into new delivery channels to broaden our population impact 


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Sara Johnson, Ph.D.
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Kerry E.
Kerry Evers, Ph.D. is Senior Vice President at Pro-Change Behavior Systems, Inc., the leading research and development company for computer-and coaching-based programs to change health risk behaviors. Her work includes the development and dissemination of health behavior change programs, as well as techniques to maximize their impact. She has over 40 published works and has been invited to speak at meetings and conferences close to 100 times both in the US and in over 10 countries. In July 2011, Dr. Evers was named one of Rhode Island’s top business people in the annual “40 Under Forty” feature in Providence Business News (PBN) based on her career success and community involvement. View Kerry E.'s Profile.
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Congratulations, Sara!

Cassie R. on 2/04/2015

I am glad to see how you have addressed smoking cessation, in particular the addition of texts as I think it is important to be innovative and adapt new methods such as texts and mobile apps.

Daniel C. on 11/10/2014

Sara has made true contributions to this field from which we will all benefit.

Joann B. on 10/31/2014

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