The effectiveness of activity trackers and rewards to encourage physical activity

Singapore: Activity trackers such as Fitbit, Jawbone, Garmin and others have become increasingly popular. However, according to a new study from the Duke-NUS Medical School, activity trackers are unlikely to help people become more active, especially given that most stop wearing the devices within a few weeks or months. The study published in The Lancet Diabetes & Endocrinology recruited 800 working adults from Singapore and randomly assigned them to a control group, a tracker only group, or tracker plus one of two types of rewards schemes. One reward group accrued rewards in cash and the other had the rewards go to a charity of the individual’s choosing. The rewards were based on meeting weekly step goals over a period of six months. The researchers assessed physical activity outcomes, including steps and activity bouts, and health outcomes, including weight and blood pressure at study conclusion and after one year, six months after incentives were removed.

Findings showed that regardless of physical activity levels of participants before the study began, activity trackers alone or when combined with rewards designated for charity did not increase activity levels. In fact, nearly half of participants were no longer wearing their trackers by the six month assessment period. In contrast, both active and inactive individuals offered cash rewards significantly increased activity levels between baseline and six months and nearly 90% continued to wear the trackers. However, at the end of twelve months, six months after the incentives were removed, this group showed poorer step outcomes than the tracker only group, suggesting that removing the incentives may have demotivated these individuals and caused them to do worse than had the incentives never been offered. Despite the step differences, activity trackers, with or without incentives, did not lead to noticeable improvements in health outcomes.

Inactivity is responsible for 9% of global deaths, reduces productivity, and drives up health care costs. For this reason, government, employers and insurers are looking for strategies to increase activity levels. Yet, lead author of the study, Eric Finkelstein of the Duke-NUS Medical School, summed up the results by stating, “Activity trackers alone are not going to stem the rise in chronic diseases.” However, he further notes that “they could still be part of a comprehensive solution and there may be a role for low cost incentive strategies, although they would likely have to be permanent to avoid any undermining effect from taking them away.” Other authors involved in the study included Benjamin Haaland, Marcel Bilger, Aarti Sahasranaman, Robert Sloan, Nang Ei Ei Khaing, and Kelly Evenson.

Funding for this study came from the Singapore Ministry of Health’s Health Services Research Competitive Research Grant (HSRG/022/2012).