Evidence-based health and well-being for entire populations.

Pro-Change Invited to Brazil for a Second Time This Fall

South Kingstown, RI – November 13, 2013. Sara Johnson, PhD, Senior Vice President at Pro-Change Behavior Systems, Inc. will address the International Forum for Investor Education in Rio de Janeiro on December 10 & 11, 2013.

Pro-Change has been invited to present at the International Forum for Investor Education by the Head of the Comissão de Valores Mobiliários (CVM), the Securities and Exchange Commission of Brazil. At the two-day meeting, Dr. Johnson will introduce the Transtheoretical Model to financial regulators and provide examples of how Pro-Change has collaborated with experts, including Jean Chatzky and Stacey Tisdale, to apply best practices in behavior change to improve financial well-being with adults and youth.

As part of Brazil’s National Strategy for Financial Education, the CVM collaborates with other federal and private organizations to deliver financial education to adults and children in Brazil. There has been an increasing awareness among the organizers of the Forum for Investor Education of the need to include behavior change theory in financial education. Jose Alexandre Vasco, the Head of the CVM said, “I personally think the Transtheoretical Model could be a key resource to design effective behavior change projects. There is a serious concern among some research papers questioning the effectiveness of education with regard to financial capability. What those studies do not capture is the quality of techniques employed, which I think are still lacking a logic model to shape the design of the intervention. I think the Transtheoretical Model fills that gap.”

While in Rio, Dr. Johnson will also meet with the CVM leadership to explore potential research opportunities to examine the effectiveness of Transtheoretical Model-based financial well-being intervention in Brazil.

In September of this year, Pro-Change provided two onsite trainings in Sao Paulo at the request of Carevolution, a Wellness company located in Brazil that offers Wellness Coach training and services.

Pro-Change Trains Health Counselors in Brazil

South Kingstown, RI – October 21, 2013.  In September, Pro-Change Behavior Systems, Inc. provided two onsite trainings to 80 AxisMed Health counselors and 70 life coaches, at the request of Carevolution, a São Paulo, Brazil Wellness Company that offers Wellness Coaching training and services.

The course entitled, Basic Transtheoretical Model Training, provided coaches and other health professionals with the basic concepts and strategies needed to effectively use the Transtheoretical Model of Behavior Change (TTM) when working with clients to change health risk behaviors. By the end of a simultaneously translated four-hour course with James O. Prochaska, PhD., Janice M. Prochaska, Ph.D., and Sara S. Johnson, PhD., learners were able to:

  • Know the characteristics of people in each Stage of Change
  • Understand the four main constructs of the TTM
  • Identify which TTM principles to employ at each Stage of Change
  • Learn effective strategies for applying each TTM principle
  • Learn evidence-based strategies for changing multiple behaviors
  • Learn the latest breakthroughs in applying the Transtheoretical Model

Ted Feder, CEO of Carevolution, stated that “It was such an enriching experience to promote and participate in Pro-Change’s training, and I feel all coaches trained felt the same way. As I mentioned to Jim, Janice, and Sara, now we want to work to offer the training online through Pro-Change’s Basic Transtheoretical Model e-Learning in Portuguese.”

Pro-Change Will Present at the CCA Conference

South Kingstown, RI – October 10, 2013.  The Care Continuum Alliance is hosting its annual conference, CCA Forum 2013, October 23-25 in Scottsdale, Arizona, with the theme, “The ROI of Population Health: Implementation Matters.” In their call for abstracts, the Care Continuum Alliance asked for “creativity, innovation, and inventiveness. Attendees want hands on learning and presentations that can demonstrate their usefulness for the population health management industry as a whole.”

In response, Sara Johnson, PhD, Senior Vice President at Pro-Change, will present on “Promoting Financial Well-Being: Why and How?” Sara will apply best practices in health promotion to designing and implementing financial well-being interventions. Potential consequences of financial distress for the individual and the employer will be discussed. Outcome measures to demonstrate effectiveness and potential return on investment will be identified.

Vice President Leanne Mauriello, PhD, will be one of six invited speakers at the Employers Training Institute at the Conference Workshop titled, “Know What You Pay For: Roadmap to Assess Success of Employers Offered Wellness Programs.” She will present on selecting and implementing successful behavior change programs for employees. Leanne will share best practices in achieving behavior change for employers. How to critically evaluate employer-based programs on quality and impact, and how to identify benchmarks for evaluating effectiveness will be illustrated.

Please join these presentations and meet Sara and Leanne if you are able to attend the CCA Forum.

About Care Continuum Alliance
Care Continuum Alliance aligns stakeholders in the continuum of care toward the goal of improving the health of populations. The care continuum includes wellness and health promotion, prevention, care coordination, and patient advocacy, condition management and complex case management. Care Continuum Alliance promotes the role of these and other strategies in raising care quality, improving health outcomes, and reducing preventable health care costs for individuals with or at risk of chronic disease. Care Continuum Alliance accomplishes this through advocacy, research, and promotion of best practices.

Pro-Change’s Founder James O. Prochaska Receives Prestigious Award

South Kingstown, RI – September 25, 2013. James O. Prochaska, PhD, Founder of Pro-Change Behavior Systems, Inc. received the 2013 Outstanding Contribution to Health Psychology Award from the American Psychological Association.

The award honors an individual who has a long and distinguished career of scientific contributions. Prochaska pioneered the Transtheoretical Model of Behavior Change, an internationally acclaimed program that encourages people to change their behavior in stages to achieve better health and well-being. Over the past 40 years, Prochaska has written and co-written more than 350 publications including three books: Changing for Good, Systems of Psychotherapy: A Transtheoretical Analysis, and The Transtheoretical Approach: Crossing Traditional Boundaries of Therapy.

“James O. Prochaska and his talented colleagues at Pro-Change and at the University of Rhode Island have established a phenomenally productive and successful series of research projects and applications that have changed the field of psychology and transformed the global understanding of the behavioral aspects of health. Their development and application of the Transtheoretical Model has helped people change from risky to healthy behaviors, improving the quality of lives,” stated Winifred E. Brownell, Dean of the College of Arts & Science at the University of Rhode Island.

Pro-Change Partners with McGraw-Hill Higher Education to Distribute liveWell Program


South Kingstown, RI – September 18, 2013. Pro-Change Behavior Systems, Inc. is now licensing its liveWell program to McGraw-Hill Higher Education for distribution to college and university students as an adjunct to their textbooks. liveWell: A Healthy Foundation for Life is an innovative online multimedia program designed to help college students improve their well-being by exercising regularly, eating healthy, and effectively managing stress.

The evidence-based liveWell program is based on the Transtheoretical Model (TTM) (or Stages of Change model) and was developed with Small Business Innovative Research funding from the National Heart, Lung, and Blood Institute. The development of the program involved extensive end-user and expert input including formative research conducted with student focus groups, usability tests, expert interviews, and input from an interdisciplinary team of college students from various U.S. colleges and universities.

A unique aspect of liveWell is that it leverages state-of-the-science best practices for tailoring of behavior change messages. Students receive a unique combination of fully tailored (exercise) and optimally tailored (fruit and vegetable intake and stress management) messages to maximize outcomes while minimizing response burden.

Consistent with Blooms’ taxonomy (i.e., Knowledge, Comprehension, Application, Analysis, Synthesis, and Evaluation), liveWell will foster knowledge gain and comprehension. The interactive online program will also offer students the unique opportunity to directly apply their knowledge; analyze multiple dimensions of the behavior change process and aspects of the health behaviors addressed; synthesize the content by creating their own behavior change plan and goals; and evaluate their progress. Robust reporting features enable instructors to track their students’ program usage, progress, and outcomes.

“College students, in particular, are in need of prevention and intervention programs because the transition from high school to college is associated with a precipitous decline in healthy behaviors,” says Sara Johnson, PhD., Senior Vice President of Pro-Change. “Recent estimates indicate approximately one half of college men and one quarter of college women are overweight or obese. We also know that physical activity declines as young adults age and more than a quarter of college students report stress severe enough to adversely affect grades or course enrollment. Thus, the need for effective, individually tailored health promotion interventions among this group is clear. We are pleased to provide an evidence-based solution to meet that need.”

Gina Boedeker, Managing Director of Products & Markets, said “McGraw-Hill is thrilled to have this innovative product offering available for students across the country. liveWell is a wonderful addition to our expanding suite of e-books and hybrid learning solutions.”

About McGraw-Hill Higher Education

McGraw-Hill Higher Education, a unit of McGraw-Hill Education, is a leading innovator in the development of 21st century teaching and learning digital solutions for post-secondary and higher education markets worldwide. Through a comprehensive range of traditional and digital education content and tools focused on improving student learning outcomes, McGraw-Hill Higher Education empowers and prepares professionals and students to connect, learn, and succeed in the global economy. For more information, please visit www.mheducation.

Pro-Change and Cooper Consulting Partners to Partner, Improve Corporate Health

Partnership adds renowned behavior change model to Cooper Consulting Partners’ Leading a Fit Life Program

South Kingstown, RI – September 6, 2013. Pro-Change, an internationally-recognized behavior change company and Cooper Consulting Partners, a health management consultancy, part of Cooper Aerobics, has announced a partnership that will further empower businesses and their employees to make healthy changes for good.

Through the agreement, Pro-Change’s Health Risk Intervention will be incorporated into Cooper Consulting Partners Leading a Fit Life program, allowing participants to receive individualized guidance and tips to make lasting change to their health. “The partnership with Pro-Change is a natural fit,” says David Atkinson, Partner for Cooper Consulting Partners. “Pro-Change’s behavior change assessment is based on extensive scientific research and evaluates readiness and how an individual can make changes. The Leading a Fit Life program develops a personal action plan for the participant to put those healthier behaviors into practice.”

Cooper Consulting Partner’s Leading a Fit Life program is an eight-week interactive program that offers employees and their spouses the opportunity to use fitness, nutrition and stress management tools to improve health and productivity which ultimately helps to control health care cost trends.

Research has shown that up to 80 percent of people are not ready to go to action right away. “Going to action is something most people have to work up to and not everyone moves at the same pace,” says Janice M. Prochaska, PhD, President and CEO of Pro-Change. “Our Health Risk Intervention is based on science and has been shown to be effective in real-life situations. It is designed to meet those individuals participating in the Leading a Fit Life program where they are in the change process.”

About Cooper Consulting Partners
Cooper Consulting Partners, A Cooper Aerobics company, is a population health management company providing a results-based strategic approach to corporate wellness for organizations who understand that healthier employees are a business imperative. Kenneth H. Cooper’s, MD, MPH, core principal is that it is easier and less expensive to maintain good health than it is to regain it once it is lost. This philosophy drives Cooper Consulting Partners, helping companies achieve maximum health and wellness with minimum impact to the bottom line. Cooper Consulting Partners offers Executive Risk ManagementStrategic Wellness Consulting, and  Executive and Healthy Lifestyle Training. For more information call 972.560.3263 or visit cooperconsultingpartners.com.

Pro-Change’s Smoking Cessation Program Also Effective for Psychiatric Patients

South Kingstown, RI – August 21, 2013. HealthDay News recently reported the results of a new study from the American Journal of Public Health (http://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2013.301403). The study showed that psychiatric patients who participated in Pro-Change Behavior System’s individually tailored smoking cessation program while they were hospitalized for treatment of a mental illness were more likely to quit smoking and less likely to be re-hospitalized.

The findings challenge a common misperception among mental health experts that smoking is a useful tool in treating psychiatric patients. The study’s lead author, Judith J. Prochaska, PhD, an associate professor at the Stanford University School of Medicine, reported that cigarettes are still used as part of a reward system on some units and that doctors may sometimes smoke with patients as a way of creating a connection.

The study conducted by Prochaska and her colleagues included 224 inpatients at a smoke-free psychiatric hospital in California who smoked at least five cigarettes a day prior to being admitted to the hospital. The patients had a range of mental health conditions, including depression, bipolar disorder, and schizophrenia. Three-quarters were suicidal. The patients were randomized into two groups. Patients randomized to the treatment group participated in Pro-Change’s Smoking Cessation program. Those randomized to the control group received usual care–which included a pamphlet about the hazards of smoking and information on how to quit.

The Pro-Change Smoking Cessation program included a computer-tailored intervention with individualized feedback and a stage-matched print manual. Patients in the treatment group also met for 15 to 30 minutes with a counselor and were offered a 10-week supply of nicotine patches when they were ready to quit smoking. The computer-tailored intervention was repeated at 3- and 6-months post-hospitalization to provide ongoing behavior change guidance through the quitting process. Patient’s outpatient providers received a copy of the patient’s report.

At the 18 month follow-up, 20% of those in the treatment group had quit smoking, compared to just 7.7% of those in the control group. Furthermore, fewer patients (44%) in the treatment group had been re-hospitalized (44% vs. 56%). The findings indicated that helping patients quit smoking did not harm their mental health recovery and may have even improved it, Prochaska said. “I think some of the therapeutic contact that addressed participants’ tobacco dependence, and supported them with this major health goal, may have generalized to them feeling better about their mental health condition,” Prochaska said in a Stanford news release.

Sara Johnson, PhD, Senior Vice President of Research and Product Development at Pro-Change Behavior Systems said, “Given that almost half of the cigarettes in the United States are sold to those with psychiatric or addictive disorders, we commend Dr. Prochaska and her colleagues for their ongoing efforts to make our population-based tailored Smoking Cessation program available to inpatients with mental illness and to rigorously evaluate its impact in this historically under-served group.”

Pro-Change’s CEO Given Achievement Award by Providence Business News


South Kingstown, RI – August 8, 2013. Janice M. Prochaska, PhD, President and CEO of Pro-Change Behavior Systems, Inc., was one of twelve women who received an Achievement Award at the 5th Annual Providence Business News Business Women’s Awards luncheon.

The event spotlighted twelve talented and dedicated women working in southeastern New England. Prochaska was recognized for being well ahead of the curve in establishing disease prevention and wellness programs and evaluating their effectiveness. Pro-Change is recognized for being on the cutting edge of changing people’s behavior to help improve their health and well-being. To do so, Pro-Change applies the best that the science of behavior change has to offer to produce high-impact solutions.

Pro-Change’s Drs. Prochaska Featured in Health Literacy’s 100th Podcast

Click here for full Podcast.


South Kingstown, RI – August 1, 2013. Health Literacy Out Loud’s 100th podcast, titled “Stages of Change and Health Communication,” went live July 30, 2013. In the podcast, James O. Prochaska, PhD, Founder of Pro-Change and Janice M. Prochaska, President & CEO talk with Helen Osborne about:

  • What the Stages of Change model is and how it got started
  • Why the Stages of Change model is relevant to health literacy and health communication, including its role in informed decision making
  • How listeners can use the Stages of Change model when communicating about health and communicating about health literacy

Recognized for her expertise in health literacy, Helen Osborne, M.Ed., helps professionals communicate health information in ways that patients, caregivers, and the public can understand. Among Helen’s many “hats,” she produces and hosts the podcast interview series, Health Literacy Out Loud (HLOL). In honor of the 100th episode of HLOL, Helen chose to interview James and Janice Prochaska on the Stages of Change behavior theory. Helen wanted to honor the Prochaskas this way, saying that “The Stages of Change model has meant so much to me and everyone else who strives to communicate health information in ways others can understand, accept, and act upon.” To hear the podcast, go to www.healthliteracy.com/hlol-stages-of-change.

Pro-Change’s Comments on the Rand Study “Do Wellness Programs Work?”

South Kingstown, RI – June 27, 2013. A growing number of sources are suggesting that wellness programs do not work. Can we answer in the affirmative that wellness programs do work? The Rand Report
(http://www.rand.org/pubs/research_reports/RR254.html) clearly indicates that such a sweeping claim cannot be supported. But why would one assume that such a heterogeneous field – filled all too often with fads, fashions, and far too few facts – would be found to have much impact?

The more critical question is: Can wellness programs work? Here we can respond affirmatively and with confidence. A national Task Force for Community Preventive Services (CHES) has been developing bodies of evidence for recommendations, predictions, evaluations, and innovations for population-based health promotion or wellness programs (Zaa et al., 2005; Soler et al., 2010). The Task Force relies on an impressive range of criteria on which confidence can be based. These include the number of studies, the consistency of results in the same direction, the magnitude of the effects and the consistency of the magnitude, the type of study design, the quality of the study implementation, and length of follow-up. To these criteria, we have added the number of replications across different types of populations, diverse sub-populations and multiple health risk behaviors, and the percentage of participants in programs. We also added strength of outcome measures. Simply measuring improvement is not as strong as the percentage of participants who progress from being at-risk at baseline to not-at-risk at long-term follow-up (e.g., from smoking to not smoking).

A Task Force team applied their original criteria to employee health promotion programs that included HRA assessments with feedback reported at least twice plus at least one additional health promotion program. Across 51 studies, they found average participation rates of about 50% and average follow-ups of about 2 ¾ years. They had confidence in concluding that these wellness programs can produce important effects with exercise (a median success rate of 15.3% from 15 arms from 12 studies) and smoking cessation (a median abstinence rate of 17.8% from 30 arms from 24 studies). Smaller effects were found with high-fat diets (median decrease of 5.4%) and no effects for fruit and vegetable consumption).

Building on the Task Force’s body of evidence, we found much higher impacts for all four of these behaviors with results from 26 arms of population-based RCTs. These results are included in a paper that will be published soon
(http://online.liebertpub.com/doi/abs/10.1089/pop.2012.0094). Unfortunately, the Rand Study did not build on the CHES body of evidence nor did it include the range or rigor of criteria that were used in their review of wellness programs. It is well known that the easiest way to prove the null hypothesis (e.g., wellness programs do not work) is to rely on weak studies. The poorer the studies, the more error and noise is produced, preventing the likelihood of detecting adequate signals of significant effects. The companies reviewed by Rand were as small as 50 employees. As with any program, product or service, there are various levels of quality and one cannot conclude that wellness programs don’t work because the “average” results aren’t impressive. Employers need to use best practices to increase the probability their efforts will reap positive outcomes. One best practice is to use programs that have been scientifically tested and shown to work and not fall to marketing claims that lack peer-reviewed evidence of their offerings.

The Rand review reports that “employers are using incentives” to increase employee engagement in wellness programs. We have been using plan design incentives with our clients for more than a decade and have been able to consistently achieve over 80% of participation rates.

What we can conclude from the Rand Report is that employers need such growing bodies of evidence, based on a broad range of rigorous criteria, in order to benchmark alternative wellness programs. With such benchmarking tools, employers will be able to predict whether they are providing high impact programs, average impact programs, or programs that will produce minor impacts and major disappointments.