One of the first things I notice when I walk into Pro-Change Behavior Systems’ South Kingstown, Rhode Island, office is the unique naming convention of the conference rooms: Theory, Stages, and Confidence. The company’s Co-Presidents and CEOs Sara Johnson and Kerry Evers tell me a member of the Pro-Change team named their conference rooms after the Transtheoretical Model, a behavior change model created by their founder Dr. James Prochaska. They tell me that the naming certainly leads to some pretty funny statements among the team like: “We have a meeting in Theory” or “Let’s meet in Confidence.”

I had the chance to talk to Sara and Kerry about how Pro-Change is pioneering a movement towards workplace well-being—leveraging technology as a key accelerator in the process—and how we can all help make the workplace a bit more excellent. Take a look at our conversation…

To begin, can you tell us about Pro-Change Behavior Systems came to be?

Kerry Evers and Sara Johnson, Pro-Change CEOs

Kerry: We were founded 21 years ago by Dr. James Prochaska, a professor at the University of Rhode Island who was a pioneer in behavior change science. In 1997, Jim was approached by a large software company out of Texas. They were going through some internal changes, and they were aware of the Transtheoretical Model that Jim and his colleagues had developed to explain the behavior change process. They asked him if he could apply that model to organizational change. Fortunately, he and his wife, Dr. Janice Prochaska, had recently been doing just that. Pro-Change Behavior Systems grew out of that work. Sara and I actually first started working for Pro-Change as URI graduate students, so we have been with Pro-Change since the beginning. We assumed ownership and leadership of Pro-Change three years ago.

Today, our goal is to partner with wellness companies and institutions to create and implement proven programs that reduce multiple health risk behaviors and enhance well-being while lowering health care costs and increasing productivity. Though we still have a background in organizational change, as a business most of our work now is focused on well-being and health.

Sara: Since then, the company has grown. We now have 20 team members, including a combination of psychologists—many of whom trained at URI—technologists, experts in public health, project managers, and computer scientists.

Your services certainly all center around igniting a behavioral change movement. Can you tell us a bit more about the services you offer?

Sara: We have four main lines of the business. The first is licensing and software-as-a-service. We have a proprietary software platform that is essentially comprised of individual health and well-being solutions. That can take the form of everything from smoking cessation to weight management to financial well-being. And that is all based on the Transtheoretical Model and incorporates AI and the data set we have developed over many years through which we can personalize behavior change guidance to each end user. There is a participant-facing version and a coach-facing version that we license to platform providers that distribute it to large employers and wellness corporations.

Our second line of business involves licensing our intellectual property to organizations who want to infuse behavior change science into their technology platforms.

Our third line of business is training and consulting services that we do on behalf of other folks, from building a brand-new intervention platform to supporting a nationwide well-being survey.

Our fourth area is research and development. We have been so fortunate to have received 30 Small Business Innovative Research Grants from the federal government which has been a real boost to our internally funded research and development efforts. Through those funding mechanisms, we are able to develop the solutions that we can then license.

Kerry: We get to work on some pretty fascinating projects! We just finished a large randomized trial in a federally qualified health center in Connecticut that was funded through the National Cancer Institute. We developed a mobile application to increase the well-being of active duty military, their spouses and veterans in an effort to decrease substance use—alcohol, tobacco and other drugs. That’s in clinical trial right now. We are also starting development on a mobile application for pain management for veterans that will be going into clinical trial within the year. We are waiting on two large grants right now and that’s just in terms of the last two years. We have many that we have done over the years.

When you look at Pro-Change versus others in the space, we have been doing clinical trials on our products for a very long time and we have a lot of evidence behind those programs and products. So that’s one of our differentiators.

Sounds like you get to have your hands in some pretty amazing projects! As you look ahead to the remainder of this year and next, what is a top focus area?

Kerry: We are embarking on a new a brand and market strategy initiative. It’s been a couple of years since Sara and I took over and we want to look at the company and put our best foot forward. One of the things we are doing in this process is really enforce the fact that we are behavior change experts. We know how to help people change behaviors. We infuse behavior change expertise to help our clients solve problems by leveraging our technologies and solutions, helping you build new technology, helping you work better with your clients or training your clients.

Sara: One of the things we find interesting is we often think about how we can facilitate behavior change for an individual but increasingly as we think about how the healthcare system is shifting, that multi-level change is going to be so important. Clinician behavior change fits in there and ultimately organizational change within the health system. We are looking at how to create synergies by operating at all three of those levels.

On the employee side, for example, as we think about creating excellence in the workplace, we are beginning to augment our solutions by equipping our clients with an assessment that gauges the extent to which employers are creating a culture of well-being within their organization and engaging in behaviors that we know are big drivers of employee engagement. For instance, are we ensuring that people have a sense of purpose in their work? Are we ensuring that our employees have meaningful social connections that are facilitated by their employer? Do they know they have someone they can count on at work? Do they have autonomy to decide how best to work? All of these drivers contribute to a better culture of well-being. We are really thinking systematically about multi-level change.

Kerry: With this assessment, we are able to help our clients find out where they are and figure out how to develop a better culture of well-being.

How much of your work is driven by client need and social movements?

Sara: It’s both. One of the programs we are working on right now, for example, is developing a pain self-management app for veterans because they are disproportionately affected by chronic pain. We wanted to start with them, but once that solution is proven to be efficacious we can really easily generalize it to a broader adult population. And pain self-management is going to become increasingly important as we address the opioid crisis.

At the same time, our Chief Science Officer is working to develop a SBIR-T intervention for primary care which is screening, brief intervention and referral to treatment for substance use. Ultimately as we assemble these building blocks we can help address things like how we can have a meaningful impact on the epidemic. We are often driven by social trends and really wanting to make a difference on things that are impacting population health and well-being.

Kerry: We will look at a population basis, like say the opioid epidemic, and then our focus is how can we help individuals change which will then bubble up to help the larger culture.

You leverage technology—like your clinical dashboard, text-messaging and suite of products—to reduce health risk behaviors, lower health care costs and increase productivity. How have you evolved the way in which you leverage technology over the years and what role does technology play in your being able to serve your market?

Sara: We are still advancing the proprietary software platform itself, but we are also trying to think really creatively about how we can best leverage technology to meet people’s needs. For example, we are currently waiting for word on a caregiver proposal that is centered around behavior change intervention to help promote the well-being of caregivers because if you can enhance the health and well-being of the caregiver, it results in better care for the care recipient. As the population ages, we are going to have a lot more caregivers and often these are people who are caring on top of their other life responsibilities. With this population, we are going to explore the power of text-only intervention where we can do brief assessment via text and send them intermittent messages matched to their level of readiness to care for themselves in order to be a better caregiver. That is a great example of how we leverage technology as a consumable medium to deliver personalized behavior change guidance.

We have also shifted how we build our platforms. We used to focus on browser-based, then mobile-responsive browser-based and now we are shifting to mobile applications.

Kerry: All of our decisions are made against the backdrop of how we can use technology as a great facilitator to bring programs to our clients. We are always trying to watch technology, see where it is going and decide whether it relates to us and how can we align what we are doing. But in addition, we work with our clients to recognize that technology is not always the best option. We have many clients who are delivering our interventions through a clinician or a coach and maybe the technology is there to support them, but the main driver is the clinician.

We have started a movement here at Trilix, educating on the importance of workplace excellence, and specifically using technology as an accelerator to business outcomes. How would you define workplace excellence?

Sara: It is so holistic. Unfortunately, no one often assumes responsibility for that; you never see Chief Excellence Officer! When I think of workplace excellence I think it’s important to bring to focus in peoples’ consciousness that excellence has to cut across all the siloes of the organization. At Pro-Change, for instance, we have a well-being committee that focusing on bringing continued growth and learning opportunities to our employees. From creating social outings to establishing a continuing education budget, we are consistently talking as an organization about how we can help our employees grow in their roles. It requires commitment to continuous improvement and being willing to evolve.

Kerry: At Pro-Change we keep our employees at the center of everything we do. We create an environment of communication and will ask our team members straight out how things are going. We hand out self-evaluations that include asking, “What can Sara and I do to make your life at Pro-Change better?” When an employee pulls us aside and says, “Thank you. I know you are doing these things and it makes my life so much better,” we know we have had impact. If you can get even one of your employees saying that, that’s enough to know you are inching closer to excellence.


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