Rolling out the Holly Health service in a primary care setting - preliminary health and wellbeing outcomes

November 10, 2022

What is Holly Health and how has it been rolled out in the care setting?

Holly Health is on a mission to improve access to personalised and evidence-based health coaching so that we can help prevent and slow the development of long-term diseases.

Millions of people are struggling with physical and mental health in the modern world, but because of resource and cost challenges, there are often limited options available. The Holly Health app combines decades of research in behaviour change, neuroscience and psychology – all in a pocket-sized digital health coach.

Digital health apps, like Holly Health, have the potential to improve personal health status by influencing personal health behaviours and avoiding health risks. However, according to research published by Nature, the long-term success of health technologies does not depend on the initial adoption, but on the continuance of use. We believe it is important to constantly investigate user outcomes and review how effectively our service is making a difference in people’s health and wellbeing.

Over the last year, Holly Health has successfully partnered with a number of GP practices from all across the UK, to trial our services and reach our goal of impacting 1 million people by 2025. So, we have used this fantastic opportunity to research the impact of our services at scale, and in doing so we have produced some exciting preliminary results.

4 Week goal check-in

Health behaviour change can be challenging for most people, but there are many strategies that can be used to help the process. According to psychological research, one of the most effective ways to achieve behaviour change is goal setting. We ask users to think about what their personal health goals might be at the start of their Holly Health journey, and then use this as a reference point to self-reflect on how far they have come.

After 4 weeks of using Holly Health, users receive an email asking whether they feel closer to their goal. Their response then triggers an optional online survey with a couple of goal-related questions. During this time, 80% of users reported feeling closer to achieving their health goal, and over 80% felt their health mindset had been changed. That is, people were actively taking everyday actions to improve their health. Research shows that empowering people to take control of their health (i.e.patient activation) leads to better and more sustainable health outcomes.

Importantly, a further 80% of users felt they had better control of their health. Throughout the Holly Health app, we use reminders and encouragement to boost feelings of achievement. One user reported that she had “really appreciated the gentle nudging and encouraging approach” as “sometimes health advice in the media can be quite pressurised”. This was also reflected by the fact that over 75% of users had also experienced a stronger ability to cope with feelings of stress and low mood.

8 Week health survey

To measure overall changes in multiple areas of health, service users were also asked to take part in an optional online health survey. This was taken before using Holly Health (i.e. baseline), and 8 weeks after. During this time, members had access to a range of health interventions, ranging from instructed exercises, educational articles and guided meditations.

Throughout the entire process, Holly Health promotes a sustainable approach to goals such as weight management in order to facilitate healthy and non-restrictive eating behaviours. This is because it is important that users first improve factors like body acceptance and self-confidence, as these predict long-term healthy habits. Therefore, it was wonderful to see 5-10% improvements across physical and mental health outcomes. In particular, exercise, self-confidence, energy and long-term mindset, had all improved in a statistically significant way from baseline.

We also assessed changed in personal wellbeing using a validated measure developed by the Office for National Statistics, the ONS-4. Users reported improved overall life satisfaction and happiness after 8 weeks of engaging with the service (also showing statistical significance).

Based on their experiences using Holly Health, over 90% of users expressed that they wanted similar services to be provided by their GP as they had found the service particularly useful.

User behaviour

By analysing the specific health behaviours that our users have been most engaging with, we can better understand where people feel they need the most support. Along with users’ favourite activities, we can use this information to further improve the features and resources on our app.

The top habit, recorded more than double as many times as all others, was stretching. This was reinforced by the ‘5-minute stretch’ tutorial also being the most frequently watched video.

Given that stretching is a low-intensity-based activity, proven to increase flexibility and increase muscle strength, it was great to see how many users had been regularly incorporating it into their daily routines. Coming in as second and third top habits, were positive body affirmations and moving for fun. Holly Health encourages both these behaviours as healthy ways to improve self-perception, and improve cardiovascular health - without feeling like a chore.

Next steps for Holly Health

Over the next year, Holly Health is on track to partner with 100 GPs and is launching local authority pilots with big UK wellbeing service providers. In doing so, we hope to reflect the positive outcomes of these results on an even wider scale - continuing to champion the health and wellbeing of our population. As our user base grows, we look forward to producing more detailed research that can be used to not only improve our services but to also provide useful public health insight.

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