Health and wellbeing outcomes from a cohort of NHS primary care patients
Holly Health is a digital wellbeing coach, on a mission to enable long-life behavioural changes using science and technology. The prevalence of physical and mental health challenges in the modern world affect millions of people, and COVID-19 has only worsened the situation. According to the World Health Organisation, the pandemic triggered a 25% increase in anxiety and depression worldwide. Chronic diseases like type 2 diabetes and heart disease are also on the rise, often requiring lifelong treatment and management.
Limited resources and high costs often prevent people from accessing the care they need. This is where Holly Health comes in. The app combines decades of research into behaviour change, neuroscience, and psychology, all in a pocket-sized digital coach. By enabling development of healthier habits and providing access to digital wellbeing advice, people are able to make small, but sustainable changes to their life.
Over the last year, Holly Health has partnered with over 100 UK GP practices, with a population coverage of over 500,000 patients. This has allowed the company to support thousands of people and to, through data, see how the app can make a genuine impact at scale.
User challenges before using the Holly Health app
Globally, one in four adults do not meet recommended levels of physical activity. With the increasing pace of modern life, finding time to incorporate healthy activities like exercise and cooking nutritious meals is difficult. The toll is not only physical either, mental health takes a hit too.
From a survey of 4,374 people, Holly Health found that 69% of users are affected by at least one chronic condition, and anxiety and depression are the most prevalent. Many people highlighted sedentary lifestyle, self-confidence, and poor dietary habits as the greatest challenges, prior to using the Holly Health app.
Eight-week outcomes: Improvements in physical and mental health
Users were surveyed before they used Holly Health, and then again eight weeks later. During that time, they were able to access a wide range of tools, including instructed exercises, personalised habit coaching, educational articles and guided meditations, all within the digital service.
Throughout the journey with the Holly Bird, people are encouraged to take a sustainable approach to achieve their health goals, like sustaining weight management by implementing flexible and non-restrictive eating behaviours. This prioritises factors like mindful eating, body acceptance and self-confidence, which are important in sustaining long-term healthy habits.
After eight weeks of using the app, the results showed clear statistically significant improvements (p<0.01) in physical and mental health outcomes across all categories. Users who started off with low to medium baseline scores increased their exercise frequency by 18% on average, and experienced a 11% average improvement in energy levels. One person reflected:
“I've never ever been able to stick with exercise habits in my life before, and thanks to Holly Health I'm now doing exercise every day regularly and I can already see a huge difference”.
One of the core components of the Holly Health service is creating long-term behaviour change by focusing on small and achievable actions. As a result, 87% of users found they were completing their healthy habits automatically as part of their normal routine after 8 weeks. This cohort was also able to better proactively engage in health-enhancing actions with long-term mindset and self-management skills improving by 15% and 14% respectively (the number of respondents ranges from 44-126 people).
Health score changes (%):
- Exercise 18%**
- Self-confidence 14%**
- Energy 11%**
- Long-term mindset 15%**
- Self-management skills 14%**
“I’m finding Holly Health way more effective than anything else I've tried because of how small and reasonable the chunks of change are”.
Echoing this experience, 33% of users (from 147 respondents) felt like they needed less GP support after using the app for 8 weeks - an encouraging sign that they felt more confident in managing their own health.
Given the high proportion of people using Holly Health that struggled with anxiety and depression, it was amazing to see the impact on mental health and quality of life. Using the ONS-4, the Office for National Statistics validated measure for personal wellbeing, statistically significant improvements were seen across all assessed areas. Out of 66 users, there was a 23% average increase in happiness and 22% reduction in anxiety vs baseline. There was also an average 20% improvement in perception of life-worth. Over 94% of users reported they would like to see their GP providing other similar digital services.
ONS-4 score changes (%):
- Overall life satisfaction 18% **
- Overall worthwhile 21%**
- Happy yesterday 23%**
- Anxious yesterday -22%**
Active behavioural changes
By analysing which health behaviours people have engaged with, the Holly Health team has been able to identify the areas in which users may need additional support. Similarly, identifying which habits and features are most popular, the team is guided towards which product areas to enhance, in order to create an even more tailored and engaging experience.
Eating mindfully and moving for fun were amongst the most popular activities. These two habits are related to approaching health from a weight-neutral approach, taking the focus away from diets and calorie counting, and towards a more intuitive way of eating and moving. User comments reflect this:
“the habits are flexible and fun and there aren’t restrictions on my diet. I can make progress slowly without having to count calories which have never worked for me in the past”
“After years of being bogged down in guilt and feelings of self-doubt every time I gained a single pound (and elation every time I lost it again), this considered and sustainable approach to living and eating happily is exactly what I needed"
Next steps for Holly Health
These preliminary findings have been extremely encouraging - they have shown that Holly Health is unquestionably helping to improve health outcomes, perceived quality of life and reduce mental health challenges.
In the coming year, Holly Health will be embarking on an ambitious expansion plan, forging new partnerships and broadening services. The company plans to collaborate with 1000 GP practices, expand its support for local authority services, and support private healthcare and insurance providers - continuously moving closer to the mission of supporting one million people by 2025.