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Exercise gains stick after financial rewards fade, new study shows


If you start exercising for the promise of a little extra money, you may keep up the habit even after the financial incentives are gone, new research from University of Western Ontario suggests.

A study of more than 580,000 Canadians across three provinces using a step-counting app showed that even when the rewards were removed after a year, most participants continued to walk almost as much.

Using the app helped walkers add about 900 steps to their daily tallies, on average (double for those who were physically inactive at the outset). When the incentives—$0.04 per day in the form of rewards for gas cards, movie tickets and other perks—went away, step counts dropped by roughly 200 steps, what Western researchers deemed “not clinically significant.”

“Ideally, you want people to go out and exercise for free. But it’s evident that’s not the case, given the high degree of obesity and physical inactivity. The fact that monetary incentives can be provided to start exercise, and not be used permanently, is a very encouraging sign,” said Sean Spilsbury, lead author of a new study published in JAMA Network Open.

“To get a ball rolling, you have to kick it. Once it’s rolling, momentum can take over,” he added of the study participants’ exercise habits.

Spilsbury completed his master’s degree working under kinesiology professor Marc Mitchell, who studies behavioral science and digital health, including previous research on the role financial incentives play on physical activity.

Participants using a now-defunct app in Ontario were receiving incentives for their walking over the course of a year, rewards that helped increase step counts by an average of 900 steps (or double that for those who had previously been inactive).

Then, the government funding was removed, the rewards mostly disappearing along with it.

The Western study examined not only Ontarians using the step-counting app, but also users in British Columbia, Newfoundland and Labrador, where incentives for activity remained during the study period and provided pseudo-control groups.

Spilsbury and Mitchell, along with co-authors Piotr Wilk, Carolyn Taylor and Harry Prapavessis, found there was a small decline—about 200 steps, on average—among Ontarians using the app once the rewards largely vanished.

Step reduction not clinically meaningful

The biggest drop occurred among those who were most engaged with the app, who walked about 330 fewer steps. Those who were inactive when incentives were available remained inactive or saw a slight increase after the rewards were gone.

The average reduction in steps was “modest,” or nearly insignificant for a person’s overall health, the researchers said.

“We’re seeing a non-clinically meaningful drop,” Mitchell said.

Those post-incentive results were exciting for the team analyzing step data.

“A reduction of 100 to 300 steps per day is promising, because that’s the gripe about incentivizing physical activity. ‘Okay, you give (rewards), and it works, but what happens when you take it away?'” Spilsbury said.

Based on the newest findings, very little changes when you take away incentives like gas, movies and other loyalty point perks.

“Governments in Canada and abroad, companies and corporate wellness programs have been interested in this approach (incentivizing physical activity). The Achilles heel has always been that it’s too expensive. This is one of the first times we’ve been able to show, with a really big sample, we can make an efficient program even more affordable, even more sustainable,” Mitchell said.

Spilsbury, who runs five times a week and loves swimming, was initially skeptical.

“I never thought anyone would exercise for money,” he said. But he enjoyed researching those who did, even with the challenges of completing his work amid the COVID-19 pandemic. It was Mitchell’s earlier work on exercise incentives that led Spilsbury to apply for his Master of Arts in kinesiology at Western.

“I love psychology. The passion I have for psychology is different than the passion I have for exercise, it kind of explains why I do it, so I like to try and find out why others do it, too.”

More information:
Sean Spilsbury et al, Reduction of Financial Health Incentives and Changes in Physical Activity, JAMA Network Open (2023). DOI: 10.1001/jamanetworkopen.2023.42663

Journal information:
JAMA Network Open

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  • Posted on November 16, 2023