affect most people’s habits in a good way,” Bosworth says. “That brings us up to April 2010, at which point we stopped and we asked ourselves the basic question that we should have asked in the first place. Why are people unhealthy, and what could possibly motivate them to change their behavior?”
Data wasn’t the answer. The Mint-like approach, Bosworth had realized, was working more like a stick than a carrot. “All these people would enter their height and weight and lab data, and immediately we would tell them, ‘You suck. You’re overweight, your blood pressure is too high, your cholesterol is too high, you must change.’ They were gone in 60 seconds,” says Bosworth. “They know what it’s doing to their life expectancy, and they still are not doing the right thing.”
That’s when Keas finally had its “come-to-Jesus moment,” Bosworth says. And one of its saviors was Chris York, a twenty-something Stanford graduate with a bachelor’s degree in psychology and three years of training in user experience design and behavior change. “He was just a kid, an intern when he started, but he knew about behavior modification,” says Bosworth. “I said, ‘Is it possible to build something that does work?’ He said, ‘You bet.’ And I said, ‘Okay, as of now you are in charge of the user experience on Keas.'”
York was promoted to product manager. And by November 1, 2010, Keas had rolled out a completely overhauled health advisory program for 1,000 employees of its first beta-test customer, Quest Diagnostics. In York’s scheme, every Mint-like element had been removed; every piece of negative feedback was replaced with some kind of positive reinforcement. It was, in essence, a game.
“What happened was astonishing,” Bosworth says. Employee engagement rates went through the roof. Under the old system, fewer than 1 percent of employees at participating companies ever posted to Keas’s Facebook-like news feed; now 30 to 40 percent posted every week. And there was very little attenuation over time.
On the strength of those results, says Bosworth, Keas “went hastily into the process of what, in this industry, is called pivoting, which is a polite way of saying that you as an entrepreneur got it wrong, but luckily for you, you had some cash left in the bank and you can start over and get it right.”
Keas’s new program works roughly like this: employees at participating companies cluster into teams of six people each, and the teams compete against each other to rack up points. Team members earn points by completing specific health-friendly actions, such as exercising five times a week, avoiding fried foods, or filling out online quizzes and health assessments. Team members can track the progress of their teammates and rival teams at their company’s private Keas portal site, where every accomplishment shows up as a post. After a set period—usually 100 days—the winning team gets a cash prize or some other incentive, and the game starts over.
At Pfizer, where 1,600 employees participated in a 12-week pilot test of the Keas program, 33 percent of participants posted to the Keas portal’s social feed—about three times the average participation rate for enterprise collaboration tools, according to the company. At the beginning of the test, only 15 percent of participants said they engaged in healthy behaviors like not smoking, exercising five times a week, and eating at least five servings of fruits and vegetables a day. By the end of the Pfizer test, that had risen to 35 percent.
Bosworth attributes such results to simple psychology. For every accomplishment—every swim, quiz, or yoga class—the game offers positive feedback. “Games are basically dopamine,” Bosworth says, referring to one of the endorphins that
